Financial Laws and Regulations Essay
1. The False Claims Act was introduced in March of 1963 to prevent people/organizations from defrauding the government. It also gives an incentive award to anyone who brings information to the government about fraudulent activities.
- A claim has to be submitted knowingly by the healthcare provider.
- If the government wants to prove that the claim was submitted knowingly, they must establish that the health provider had knowledge of the claim submission.
- If someone knowingly makes or uses a false record or fraudulent claim from the government. For example a doctor submits a bill to Medicare for services that were not performed.
- The Government needs to present a preponderance of evidence to establish its case.
- Any claim that is submitted with the intent to defraud is fined anywhere from $5,500 to $11,000 per claim and more than that including the damages caused to the federal program. (Cleverly, Song, & Cleverly, 2011).
2. The three broad objectives HIPAA privacy standards were designed to accomplish are to limit the circumstances in which individuals use and disclose patient health information, establish individual rights regarding patient health information, and require protected individuals to adopt administrative safeguards to protect the confidentiality and privacy of patient healthcare information. According to our text, HIPAA prohibits the disclosure of any individual health information that is transferred or maintained electronically, such as emails and faxes. HIPAA privacy standards also ensures that individuals have right of deciding which information should not be disclosed under any circumstances. Finally, HIPAA privacy standards also ensure that all security standards are followed by all covered individuals in order to protect personal health information.
3. Stark law, also known as ‘the physician referral law’ prohibits a physician from making...