Discuss the most common federal regulatory issues, such as fraud and abuse, Stark Law, HIPAA, EMTALA,...
Discuss the most common federal regulatory issues, such as fraud and abuse, Stark Law, HIPAA, EMTALA, and IRS requirements for tax-exempt organizations, as well as less common concerns that arise under the antitrust laws and federal and state laws regulating third-party payers.
Homework Answers
The most common federal regulatory issues are discussed below
A. FRAUD AND ABUSE: These are the federal fraud and abuse laws that are practised in the healthcare industry. The five most important fraud and abuse laws that are applied to physicians are
1. FCS
2. AKS
3. stark law
4. CMPL
5. The exclusion authorities
B. STARK LAW: Stark law is a set of many other laws. It states that the physician is restricted of referring a patient to healthcare service if the physician has a financial deal with that entity
C. HIPAA: HIPAA stands for Health insurance portability and accountability act. This law came into act to provide patients medical records safe and private. Privacy of patient’s medical condition is the main concern of this act
D. EMTALA: EMTALA stands for emergency medical treatment and labor act. This was released in the year 1986 by united states. In this act the patient coming to hospital in emergency should be treated first regardless of their insurance policy status.
E. IRS requirement for tax exempt organisation: this is the organisation that has 50 thousand dollars receipts that are required to file exempt organisation
The less common concerns that arise under the antitrust laws and state and federal laws regulating third party payers are
1. Antitrust laws are against corruption
2. Antitrust laws are against innovation
3. state cannot go against federal laws, federal is applied to nation and state laws are for the particular state
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Discuss the most common federal regulatory issues, such as fraud
and abuse, Stark Law, HIPAA, EMTALA,...
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