Legal Aspects of HC 3-5 Flashcards
role of DOJ
investigate false claims
OCR stands for what and what do they do
Office for civil rights. role = HIPAA, non-discrimination
fraud vs abuse: comes down to what
intent
fraud
when someone inentionally deceives to obtain money
abuse
when HC providers perofrm actions that directly or indirectly result in unnecessary costs to any HC benefit program
key for documentation to prevent fraud/abuse
must have evidence in your documentation that there was medical necessity for the treatment you gave
Fraud and Abuse: APTA code of ethics
PT’s shall demosnstrate integrity in their relationships w/ pt’s, students, etc.
PT’s will provide truthful, accurate, and relevant info and hsall not make misleading representations
Reverse False Claim - what do providers do?
Reverse False Claim: when providers knowingly retain MEdicare/Medicaid overpayments they are not entitiled to
Reverse False Claim extends liability to what
to the retention of overpayments received, whether you intended to receive them or not
T/F once you idenity you’ve been overpiad by the got, you have an obbligation to repay them
true
After ____ days, you are at risk of being accused of a false claim if you do not pay Medicare back for overpayments
60 days
What is a whistleblower
an employee who reports employer illegality to a govt or law enforcement agency
do laws protect whistlerblowers?
YES! Many laws exist that protect the actions of legitimate whistleblowers
