Medical Office Abuse

Health Care Fraud and Abuse - Hopkins Medicine

https://www.hopkinsmedicine.org/johns_hopkins_healthcare/providers_physicians/health_care_fraud_and_abuse/

Abuse is defined as practices that are inconsistent with accepted sound fiscal, business, or medical practices, and result in an unnecessary cost or in reimbursement for services that are not medically necessary or that fail to meet …

You suspect a patient is being abused.

https://www.ama-assn.org/delivering-care/patient-support-advocacy/you-suspect-patient-being-abused-what-should-you-do

In Opinion 8.10, “Preventing, Identifying and Treating Violence and Abuse,” the Code explains that all patients may be at risk for interpersonal violence and …

Health Care Fraud — FBI - Federal Bureau of Investigation

https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud

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 …

Preventing Health Care Fraud and Abuse - AAP

https://www.aap.org/en/practice-management/liability-and-regulation/preventing-health-care-fraud-and-abuse/

Information about protecting your pediatric practice from fraud and abuse as well as details on key elements of compliance programs. Preventing Health Care Fraud …

Filing complaints about a doctor, hospital, or provider

https://www.medicare.gov/claims-appeals/file-a-complaint-grievance/filing-complaints-about-a-doctor-hospital-or-provider

To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board. Complaints about the quality of …

Top 5 Most Common Healthcare Provider Fraud Activities

https://healthpayerintelligence.com/news/top-5-most-common-healthcare-provider-fraud-activities

OIG found that in in Westlake, OH, a provider fraudulently overbilled Medicare private payers for several unnecessary services. Unnecessary services …

Reporting Fraud | CMS - Centers for Medicare

https://www.cms.gov/About-CMS/Components/CPI/CPIReportingFraud

Health & Human Services Office of the Inspector General Website By Fax Maximum of 10 pages 1-800-223-8164 By Mail Office of Inspector General ATTN: OIG …

How to identify and report health care fraud

https://www.journalofaccountancy.com/issues/2020/mar/how-to-identify-report-health-care-fraud.html

Suspected abuse of Medicare — the federal insurance program for people 65 and older — should be reported to the U.S. Department of Health and Human …

Report Medical Fraud | U.S. Department of Labor

https://www.dol.gov/agencies/owcp/dcmwc/reportmedicalfraud

Medical Providers. Information on Bill Processing for the Federal Black Lung Program; Information for authorized providers of diagnostic services; Telehealth Billing Guidance …