Final rules list penalties for fraud, patient abuse

Article Abstract:

Final government rulings were issued on when physicians may be booted from Medicaid and Medicare programs due to fraud. Some of the conditions for exclusion include patient neglect or abuse. Similarly, physicians having their licenses revoked or suspended for reasons related to performance, competence or financial irregularities, may also be excluded. And finally, any physicians convicted of fraud involving kickbacks, reimbursement on false claims or abuse of controlled substances will be excluded from the Medicaid and Medicare programs.

Admin. of social & manpower programs, Accident and health insurance, Health insurance industry

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Federal managed care bill would lift gag

Article Abstract:

The proposed "Patient Right to Know Act" would prohibit "gag clauses" in physicians' contracts. "Gag clauses" restrict doctor-patient discussions about alternative treatment options based on insurance companies' economic interests. The proposed bill, which was co-sponsored by Rep Edward J. Markey and Rep Greg Ganske, is a result of complaints against health care plans that withhold information about treatment options. The legislation is supported by the American Medical Association and other health groups.

Health Care and Social Assistance, Medical & Health Services, Political activity, Medical care, Physician and patient, Physician-patient relations, Markey, Edward J., Ganske, Greg

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Cracking down on fraud

Article Abstract:

Representatives Pete Stark and Sander Levin introduced a bill that would impose stiffer penalties and stricter claims standards on physicians in an effort to end fraudulent billing practices. The bill, which addresses problems in both private and public reimbursement systems, would require establishment of a common coding system. The coding system would help track billing practices. The legislation would also affect Medicaid and Medicare billing procedures.

Offices & clinics of medical doctors, Legislative bodies, Physicians, Medical professions, Social policy, United States. Congress. House, Stark, Pete, Levin, Sander M.

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