虚假申报法信息

作为联邦医疗保健计划资金的接受者, 包括医疗保险和医疗补助, healthcare organizations are required by law to provide all employees, agents and contractor’s information regarding the federal False Claims Act, 联邦项目欺诈民事救济法案, and any applicable state laws intended to prevent and detect fraud, 联邦医疗保健计划中的浪费和滥用.

什么是虚假申报法(FCA)?

The FCA is a federal law that makes it a crime for any person or organization to knowingly make a false record or file a false claim with the government for payment. “Knowingly” includes having actual knowledge that a claim is false, or acting in “deliberate ignorance” or “reckless disregard” as to whether a claim is false. Examples of possible false claims include billing Medicare for services that were not provided, billing for a higher-level service than the service actually furnished (upcoding), 或者为非医生要求的服务买单.

The FCA contains provisions that allow individuals with original information (i.e., information not already the subject of legal proceedings or activities that have already been publicly disclosed) concerning fraud involving government programs to file a lawsuit on behalf of the government and, 如果诉讼成功了, 领取政府收回款项的一部分. 纽约在2013年更新了《亚洲十大博彩公司排名》.

违反虚假申报法的处罚

Financial penalties to the organization for submitting a false claim can total as much as three times the amount of the claim plus fines up to $50,每宗索赔000英镑. 除了罚款和处罚, an individual or organization that violates the False Claims Act is subject to exclusion from participation in federally funded healthcare programs. 纽约’s False Claims Act provides for a penalty of between $11,803美元和23美元,331 per claim and recoverable damages between 2 and 3 times the value of the amount of money falsely received.

《亚洲十大博彩公司排名》的保护

有一个 , tam, or whistleblower, provision in the Federal and NYS False Claims Acts, as well as the 宾夕法尼亚州举报人法. 这一规定允许普通公民(被称为公民) 关系词), to file a lawsuit against an organization or an individual on behalf of the government if the relator is aware of a potential false claim. A relator/whistleblower can receive a portion of the settlement dollars recovered. 亲属/举报人也受到特别保护 , tam 联邦，纽约州和宾夕法尼亚州法规的规定. The provision protects employees from retaliation by an employer or employee for reporting potentially fraudulent activity.

宾夕法尼亚州医疗补助欺诈和滥用控制法

The 宾夕法尼亚州医疗补助欺诈和滥用控制法 (“Medicaid Fraud Control Act”) provides a criminal remedy for the submission of false or fraudulent claims to the 宾西法尼亚 Medicaid program. The Medicaid Fraud Control Act prohibits any person from, among other things:

  • Knowingly or intentionally presenting for allowance or payment any false or fraudulent claim or cost report for furnishing services or merchandise under the Medicaid program;
  • Knowingly presenting for allowance or payment any claim or cost report for medically unnecessary services or merchandise under the Medicaid program;
  • 故意提交虚假信息, for the purpose of obtaining greater compensation than that to which he or she is legally entitled for furnishing services or merchandise under the Medicaid program;
  • 故意提交虚假信息 for the purpose of obtaining or furnishing services or merchandise under the Medicaid program.

项目欺诈民事救济法

The 项目欺诈民事救济法 ("PFCRA") provides federal agencies, including the agencies responsible for federally funded health care programs, with administrative remedies against individuals and organizations that knowingly submit a false claim for payment, or knowingly make or use a false record or statement to get a false claim paid. PFCRA仅限于虚假索赔的情况, 或者是一组相关的虚假声明, 不超过150美元,000. PFCRA规定民事罚款最高可达10美元,每件虚假索赔781美元, 加上相等于虚假申索款额两倍的评税.

世界博彩公司十大排名对企业合规的承诺

The Guthrie Clinic is committed to fully complying with all laws and regulations that apply to our organization. The Corporate Compliance Program is evidence of the commitment to operating with the highest degree of integrity. 合规计划包括行为准则, 政策和程序, 培训和教育, 审核和监控, and mechanisms for individuals to raise issues and concerns without fear of retaliation.

我们要求您:

  • 在你所有的商业活动中诚实正直.
  • Follow all laws and regulations that apply to your work activities, 包括医疗保险的要求, 医疗补助和其他联邦医疗保健计划. These requirements generally include maintaining complete and accurate medical records, and submitting only complete and accurate claims for services provided.
  • Contact one of the following resources available within Guthrie if you have knowledge or concern regarding a potential false claim:

世界博彩公司十大排名诊所的政策严禁报复, 以任何形式, against an individual reporting an issue or concern in good faith.

Thank you for your commitment to operating with integrity and the highest standards of ethical behavior.