Fraud and Abuse Investigations Handbook for the Health Care Industry

If you are not an AHLA member and would like to purchase this title, click here. Understanding the powers, procedures and remedies available to the government during a health care fraud and abuse investigation, and acquiring a basic understanding of the issues and practical steps to employ during an audit or investigation, are keys to surviving the investigation and achieving a favorable outcome. This new Handbook will arm health care administrators, executives, medical directors, office managers, physicians, and medical practice managers with a broad understanding of this industry- specific area of government enforcement. The resource is complete with: * Clear and concise explanations of the law * Sample government documents, affidavits, and subpoenas accompanying each chapter * Illustrative pleadings and memoranda prepared by prosecutors and defense attorneys The authors detail the nuts and bolts of a fraud and abuse investigation, from an overview of the various federal and state enforcement agencies to the potential of settling a case. Learn what to expect and how to respond with coverage of: * Requests to examine books and records dealing with an organization's programs and operations * Interviews of employees by the OIG or the FBI * The power of HIPAA administrative subpoenas and the broad authority granted under this statute * Steps that should be taken in responding to the government's request * Dealing with on-site demands for records and access * Internal audits and investigations * Voluntary disclosures * Affirmative actions to try and fend off an investigation, plea agreements, and deferred prosecution