President George Bush proposed a two part strategy with initial implemented drug coverage to low-income beneficiaries coupled with a White House task force to develop a plan to reform Medicare (Health Policy, 2001). Under this plan beneficiaries with income 135% below the national poverty guidelines would be eligible for full prescription drug coverage and a sliding scale would be provided for those under 175% (Health Policy 2001). The most controversial

Fraud and Abuse Case Healthcare fraud and abuse continues to threaten the country, costing the facility billions of dollars per year. Brodeur, (2007) stated that fraud is something difficult to understand because it is a contagious issue. Healthcare fraud and abuse according to Brosman & Roper (2007) is the most profitable thing one can take part in if he/she is a crook, it avoid all channels and legal procedures, in nutshell,

The safe harbors do not cover every area of permissible behavior, and an arrangement may not qualify as a safe harbor, but still not subject someone to the risk of prosecution. In fact, the courts have interpreted the Federal Anti-Kickback Law relatively narrowly. The court in Feldstein v. Nash Community Health Servs., 51 F. Supp.2d 673 (E.D.N.C. 1999), implied that the government has to show that a defendant knowingly intended

This site contains no information directly related to the problem of substance abuse within the profession. The industry related information on the workplace environment is geared towards serving the nursing professional, and especially protecting their rights in the various nursing workplace settings. It begs the question of why, when substance abuse is a problem in the profession, the site offers no resources to the nursing professional as to where they

Furthermore, we cannot forge a safe harbor under 42 C.F.R. §1001.952(p), because Sundown Community Hospital is not a physician's group (Altshuler, Creekpaum, & Fang, 2008). Finally, the proposed arrangement does not fall within the safe harbor provided for investments in group practice because the hospital would not meet the criteria of: equity interests held by licensed professionals; equity interests being in the entire practice; unified business with unified decision

Fraud and abuse present significant problems for the healthcare sector, leading to both financial losses and reduced quality of care. The outcomes of fraud and abuse are similar; but fraud and abuse are legally differentiated based on motive. According to Magellan Healthcare (2019), fraud is committed with clear intent, whereas abuse “involves actions that are inconsistent with sound fiscal, business or accepted behavioral healthcare practices,” (p. 1). Determining intent to