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Take A Break from the Negative Effects of Health Care Fraud September 27, 2017

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Fighting health care fraud as a fulltime job can be a taxing.  Fighting to recoup money lost through waste, fraud and abuse has been the aim of the Health Care Fraud and Abuse Control (HCFAC) program since it began twenty years ago.  Through their capacity to fight using powerful tools and alliances, they have been successful in winning judgements, settlements, and impositions in many cases, and have returned more than $31 billion to the Medicare Trust Funds.  This would not be possible without cooperation between the government and the private sector.  If fighting health care fraud is your goal as a health care attorney, taking good care of yourself is just as important as catching the cheats working around the country to steal taxpayer’s money.

health-care-Pouring over evidence, interviewing witnesses, and flying around the country can be demanding work.  It’s rewarding when your team gets a judgement in your favor, but you must take care to spend some downtime and do it in a place that allows you to unwind and recharge so you can live to fight another day.  RIU Resorts offers the ideal setting for such breaks.  They have a group of all-inclusive packages that covers everything from your accommodations to meals.  Just imagine yourself on a sandy beach with the sun setting over the Pacific Ocean in RIU Mazatlán while you take in the view from the balcony of your suite.  This is not the end of a day chasing leads, it’s the end of a week of ecstasy.   And when you use a Groupon promo code celebrating RIU’s 20th anniversary, you’ll realize savings sure to help you clear your mind of all the arguments back and forth about culpability.  Getting away from the daily grind is good for your health.  You want to be strong enough to fight another day for others, so you’ve first got to be mentally and physically strong enough yourself.   Replace memories of a stress filled day in court with memories of long walks along sandy white beaches, cocktail hours, superb dining, and entertainment.

There’s been lots of research about the positive effects of negative ions on the human body.  Negative ions naturally occur when you’re near moving bodies of water, like the ocean.  There, the negative ions trap pollens and pollutants and cause them to drop out of the air you breathe.  Just like the oceans effect on the negative ions at the beach, RIU can have a positive effect on you.  They have enough freshwater pools, and sandy beaches to rid you of the negative effects in the air and the courtroom.

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What Is Healthcare Fraud and How Can You Spot It? July 10, 2017

Health Care Law

Health care fraud is a type of fraud involving the use of the health care system by an individual, medical provider or insurance company in a deceitful manner in order to profit from it. health care fraud influences insurance rates every day, therefore causing premiums that individuals pay to rise to cover the insurance companies’ losses. the laws regarding health care fraud vary by jurisdiction though both state and federal laws are in place to curtail and punish this crime.

Types of health care fraud

because the individuals, medical providers and insurance companies commit fraud, there are many types of health care fraud. however, the primary goal of such fraud is to profit financially or even to obtain medical care without valid insurance. the following are various types of health care fraud;

  1. fraud committed by medical providers
  2. i) Billing for services and procedures that were not provided to the patient
  3. ii) Duplicate submission of a claim for the same service when it was only performed once

iii) Billing for a different and more costly service than the one rendered

  1. iv) Billing each step of a procedure as if it was separate procedure
  2. v) Providing a service that is not covered under a patient’s insurance policy then billing for a service that is covered. check more here 
  3. Fraud committed by individuals
  4. i) Using insurance that belongs to someone else
  5. ii) Failing to remove someone no longer eligible for a policy

iii) Visiting different doctors to obtain multiple prescriptions

  1. iv) Exaggerating a claim
  2. v) Providing false information in order to receive medical coverage.
  3. Fraud committed by companies
  4. i) Collecting premiums for policies on which they do not intend to pay
  5. ii) Evading state insurance regulations to sell health care insurance they are not licensed to sell

iii) Denying payment on services, procedures or even prescriptions that should be covered.

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  1. i) Patients can look for fraud by paying close attention to their bills and also reporting discrepancies to the authorities. However, if you notice that a doctor billed you for significantly more time than they spent with you, it could be a sign of fraud. Also, if they charge for services that you never received that could indicate fraudulent activity.
  2. ii) Do not accept medical advice unquestioningly. This is whereby, when there is a fraud, the party involved may try to persuade you to get tests or treatments you do not need, while the vast majority of healthcare professionals are trustworthy, you should also need to be your own best advocate.

iii) Staying alerted at the doctor’s office. When in doubt, most of us turn to our doctors, however, though it is rare for the healthcare providers to sometimes be the ones who are perpetrating fraud. Therefore, fraud of this kind may follow several forms as;

  1. a) Being charged for a service you did not receive
  2. b) Being charged for a service that is more expensive than the ones you received
  3. c) Being charged for the same thing twice

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The right Lawyer to Defend Health Care Fraud December 2, 2016

Any attempt to defraud the government is a serious offense thus you need health care lawyer. It becomes even more serious if it involves attempts to defraud the health care system. Whether it is a medical service provider or a consumer, facing health care fraud charges can be a tough time. What you need to do is find a criminal defense lawyer immediately.

Any misrepresentation in the filing for health care benefits may be interpreted as a criminal activity. Without active and timely health care fraud attorney, it is very difficult to handle such situations and avoid conviction.

Which circumstances may lead to such criminal charges?

Here is a look at a few examples.

  • Billing services that were not provided/filing claims for services you did not avail
  • Misrepresenting procedures to get coverage for non-covered medical treatments
  • Falsifying reports or bills to claim more from insurance carrier
  • Providing medical records of patients to third parties

Why would you need active defense?

The penalties for health fraud are serious. It may include 10 years imprisonment and/or hefty fines. If the fraudulent activity results in bodily harm to anyone, the period of imprisonment may go up to 20 years. You may face life imprisonment if the fraud results in the death of another. Visit this site : federal-lawyer.com

Getting a health care fraud attorney from the very first stage is imperative for proper handling of the matter. Health fraud defense requires thorough investigation of the facts and analysis of the applicable laws. Only a lawyer competent in this field would be able to find the right strategies for defense.

Plea bargaining may also work in your case

However, this is only a possibility if the prosecution offers this. In this, the prosecution files lesser charges, or gives you some other benefit, in lieu of which you plead guilty. This saves time and effort, and may be a good choice if it is difficult for you to use any other defense.

Certain affirmative defenses work well for this white-collar crime. One such is entrapment – when the inducement of a government agent/agency is the chief reason for your committing the crime, and you would not have committed the crime if this inducement were not there for the health care lawyer. Click here !

To conclude:

Only a good health care fraud attorney would be able to take care of the responsibilities. Whether it is helping you to understand the terms of the plea bargain or accumulating and presenting evidence at trial, knowledge and experience are imperative for handling the defense of a criminal case.

Making a Difference

Protect your right to health insurance, lower your premiums and keep your medical information safe. All it takes is a little education, a watchful eye, and the willingness to make a difference with health care fraud attorney!

To conclude:

Health insurance fraud represents one of America’s largest taxpayer rip-offs ever, costing Americans literally billions of dollars every year. Due to rampant deception, scams and abuse in the health care system, consumers are forced to pay the price–literally–through escalating medical costs and rising health insurance premiums.

And government programs like Medicare and Medicaid, designed to help the low-income and elderly, represent two of the biggest losers of all or seek Health care fraud attorney.

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Appeals Court Hears Another Challenge to Health Care Law November 7, 2016

Health Care Law

The Constitution of the United States grants certain powers to the federal government. Since President Obama’s Health Care Reform Act was passed, many health care lawyers have questioned whether or not the government has overstepped its bounds by passing this law. Another lawsuit has been filed in the aftermath of Obamacare, this one in the 11th Circuit Court of Appeals.

26 states filed the lawsuit in Florida, where a judge deemed the overhaul plan to be unconstitutional. The federal government has appealed the decision, and it is currently being heard by the US Court of Appeals for the 11th Circuit. A group of small businesses and individuals are urging the court to uphold the decision which finds this law to be unconstitutional and unenforceable.

The Court consists of two democrats and one republican, all appointed to the Court. Their biggest concern is that this overhaul plan opens the door for the Federal Government to pass other sweeping mandates that would affect all Americans.

The health care plan hinges on several key factors. The one that is causing problems in court is the requirement that all people carry health coverage.

The individual mandate requires that all Americans have health insurance or face fines and penalties. The question asked of the government by Chief Judge Joel Dubina was, “If we uphold the individual mandate in this case, are there any limits on congressional power?” Judges Frank Hull and Stanley Marcus also expressed this same concern.

The country was founded with a strong belief that power should be split and balanced, to prevent any one group from exerting too much control. This single piece of legislation could theoretically undermine the balance of power that is central to how the country operates.

The response of the acting US Solicitor Neal Katyal is that health care is unique. Because it affects millions of people and health care lawyers, the government claims that the legislative branch has the power to regulate it because of the substantial effect on the economy. They claim that their actions will solve a national problem, making this a one-time event and not the start of a country down a slippery slope.checkout website from http://www.wsj.com/articles/obama-defends-health-care-law-1476999645 for more tips.

Former US solicitor Paul Clement argues that the government is essentially mandating people to make a commercial transaction, and that crosses the line between solving a problem and exceeding their authority.

Health Care LawJudge Hull doubted that this part of the Health Care Reform Act is truly necessary to the entire package. She expressed that other parts of the package could compensate for removing the individual health care mandate, including expanding Medicare discounts for seniors and the preexisting medical conditions aspects. Judges Hull and Dubina also questioned health care lawyers on both sides as to the effect on the Health Care Reform Act if just this one provision were invalidated in the courts.

Comparing quotes online for health insurance can save you a lot of money as you will be able to compare the rates offered by multiple insurance companies. It only takes a few minutes to see which insurance company offers the best price for you. There are so many sources of information which are also important to know because you never know you will need it in the future. Health care is very important, give some effort to find details about it or speak to a health care lawyer today.

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6 Ways Health Care Directives Fail

Health Care Directives

As mentioned by most health care lawyers, one of the most important pieces of a person’s estate plan is the Health Care Directive. Simply put, the Health Care Directive (or HCD for short), spells out how a person wants to be cared for when they become disabled. I say when they become disabled, because people are six times more likely to become disabled than die in a given year. We will all be disabled at one point; it could be the last 20 minutes of our life or the last 20 years.

Because of the risks of disability, it is wise to have your health care wishes legally stated. This is where the Health Care Directive comes into play. The HCD will state the treatments or procedures you would like once you become disabled. Additionally, the HCD will state the treatments or procedures you would not like. In fact, stating what you would not like may be just as important.

Since it is such an important document, the HCD should be reviewed every three to five years. Just like a Will or a Trust, the HCD may need to be updated. Here is a list of six ways that Health Care Directives fail:

1. Not in Doctor’s Hands (Accessibility) –When the time comes for you to use your Health Care Directive, you may not be conscious. If that’s the case, you will want your HCD to be in your doctor’s hands when you arrive at the hospital. In fact, this is a simple step that many people do not take, which can lead to your wishes being dismissed when a new HCD is created (see #6).

2. No HIPAA Authorization – An incredibly important document that should accompany your Health Care Directive is a HIPAA Authorization. HIPAA stands for the Health Insurance Portability and Accountability Act. This document authorizes other Loved Ones to receive updates on your treatment status. If you are an elderly parent, you may want your adult children to know about your health.

3. Not Properly Written – A Health Care Directive that is poorly written will not get better with age! Different people want different options when it comes to deciding their healthcare choices. Usually a “template” HCD cannot offer these choices.

4. Wrong Parties – The people whom you designate on your HCD should actually be the people you want to make decisions on your behalf. Surprisingly, I have seen many HCDs that spell out the wrong people (or parties).

5. Old / Out of date – What happens when the person you designated as your Agent seventeen years ago has already passed away? Or what happens when your Agent has moved to California and won’t be able to travel to Minnesota? An out of date HCD is a ticking time bomb.

Health Care Directives6. Revoked By Accident – Yes, this happens. In fact, it can happen quite easily. Here’s how: if the doctor at the emergency room asks your spouse or child about a HCD and they are unsure, they may sign a new “template” HCD right in the emergency room lobby. Chances are, this “template” HCD may not be the same as the well thought out version you completed with your attorney while you were peaceful and sound of mind.view more updated blog post http://www.valleymorningstar.com/life/health_wellness/article_6d18d11e-a160-11e6-bcac-eba4746f4cac.html

A Health Care Directive is an essential part of most people’s estate plans. However, it must be reviewed regularly to ensure that it continues to protect you as you wish. It’s a good idea to talk with an experienced health care lawyer to see what is best for you.

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10 Things Pre-Boomers Need From Health Care Reform

Health Care

With several bills coming out of both houses of congress, the health care discussion by health care lawyers appears to be far from over even though the administration wants legislation signed this year. The politics of reform are intensifying each passing day. Therefore, without regard to party affiliation, I’ve tried to identify key points for pre-boomers to consider when it comes to health care reform.

The following 10 points are in no particular order.

And, I purposely do not take into consideration what other age or demographic groups may want or need. As a pre-boomer, I believe the items listed below are, or should be, the deal breakers in any health care bill offered to my generation (those born between 1930 and 1945).

1. Ability to keep current doctor(s) and be able to visit them as needed.

2. Assurance of complete and consistent health care until death.

3. Portability of insurance, because seniors do move.

4. Coverage will not be given other groups at the expense of seniors.

5. Allow competition among insurance companies so premium costs can be lower.

6. Insurance companies cannot cancel secondary coverage no matter what.

7. No extra premiums or denials for pre-existing conditions.

8. Any reform must be deficit neutral to keep taxes from going up.

9. Test proposed plan elements rather than initiate immediate, sweeping changes.

10. Eliminate Medicare and Medicaid waste, fraud and abuse, as promised.

Reducing Medicare and Medicaid funding by over $600 billion in order to provide insurance for those currently not covered is not going to fly with most new seniors, certainly not this one. Don’t you wonder how many people are truly uninsured because they can’t afford the premiums or have pre-existing conditions versus those who, for whatever reason, choose not to buy insurance or are here illegally?

The notion that more than a half a trillion dollars in saving can be achieved by reducing waste, health care fraud and abuse is highly questionable. And if it were true, why didn’t the government take steps to realize these savings before the current debate heated up? So someone needs to identify the problems and fix them now.

There have been many implied promises but no guarantees that seniors will not be placed on some kind of rationing or other changes which result in reducing the quality of our health care and health care fraud in the years ahead. So we must be skeptical until the details are revealed.visit site from http://www.wsj.com/articles/worst-performing-stocks-of-2016-health-care-1478433602 for more info.

Health CareIn the meantime, keep the pressure on our representatives in Washington. Ask how they intend to deal with the above 10 points, plus any others you can think of. If we are respectfully persistent with questions, maybe the politicians will get the idea that pre-boomers are serious about our health care coverage. However, should they not be responsive to our needs, and then we don’t need them anymore. And we’ll vote for someone who is willing to listen to the generation of new seniors.

Don Potter, a Philadelphia native, was born in 1936 and is a 50 year veteran of the advertising agency business. Now living in Los Angeles, he has written two novels in retirement, frequently writes on marketing issues, and has a blog dedicated to pre-boomers (those born between 1930 and 1945).

Read more articles for and about pre-boomers with thoughts, comments and opinions designed to spark thinking, foster discussion, and stimulate debate by logging on to this link.

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