Fraudulent Medical Documentation

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Documentation Matters Toolkit | CMS

https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Program/Education/Documentation

Accurate documentation supports compliance with federal and state laws and reduces fraud, waste, and abuse. Documentation Matters Fact Sheet for Medical Professionals (PDF) (3 pages) …

Preventing Fraud and Abuse in Clinical Documentation

https://library.ahima.org/doc?oid=301028

Preventing Fraud and Abuse in Clinical Documentation. By Mary Butler. The HIM Problem: The US Department of Health and Human Services’ Office of the Inspector General (OIG) …

Fraud & Abuse Laws - Office of Inspector General

https://oig.hhs.gov/compliance/physician-education/fraud-abuse-laws/

False Claims Act [31 U.S.C. § § 3729-3733] The civil FCA protects the Government from …

Former VA Psychologist Charged With Submitting False …

https://www.justice.gov/usao-sdil/pr/former-va-psychologist-charged-submitting-false-medical-documents-employer-obstruction

According to court documents, between November 2016 and August 2020, Kelly submitted fraudulent medical documentation in the name of real and fake …

Medical Record Entry Timeliness: What Is Reasonable?

https://www.aapc.com/blog/23844-medical-record-entry-timeliness-what-is-reasonable/

Compliance Tips on Comment #4: Legibility of medical record documentation is not just a billing issue; it is a patient care issue. Illegible …

What Are the Consequences of Falsifying Medical …

https://legalbeagle.com/8396562-consequences-falsifying-medical-records.html

Altering a medical record can lead to a world of trouble for the medical practitioner, even if the alteration just clarifies what actually occurred. Meaning of …

Western District of Michigan | Health Care Fraud

https://www.justice.gov/usao-wdmi/health-care-fraud

Health care fraud occurs when an individual, a group of people, or a company knowingly mis-represents or mis-states something about the type, the scope, or …

9 Red Flags Signifying Healthcare Fraud & Abuse

https://www.mosmedicalrecordreview.com/blog/9-red-flags-signifying-healthcare-fraud-abuse/

The medical chart shows treatment provided on an unlikely day: Routine medical treatment is not usually provided on holidays, Sundays, or on days following an emergency or a disastrous weather …

8 U.S. Code § 1324c - Penalties for document fraud

https://www.law.cornell.edu/uscode/text/8/1324c

The decision and order of an administrative law judge shall become the final agency decision and order of the Attorney General unless either (A) within 30 days, an official …

Ask the Expert: We Think Our Employee Is Falsifying …

https://hrdailyadvisor.blr.com/2017/04/06/ask-expert-think-employee-falsifying-doctors-notes/

Answer from the experts at HR.BLR.com: Thank you for your inquiry regarding requesting verification of suspicious doctor’s notes. Because of the sensitivity of health …

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