Financial Health 2 - Assignment Example

ost of care payment is similar to the comprehensive care model in which payment for the full range of health care is given by a specified group for a decided period of time. (Cromwell, J., & Research Triangle Institute. 2011) The false claim act is a statute which provides people who are not with the government to file action can on behalf of the government. It is a federal law also known as “whistle blowing” that allows people who are not government-affiliated to file claims of fraud against the government.

It has been used to investigate many health providers from pharmaceutical companies to health care organizations, hospital, practices, agencies and equipment providers. Through the use of this fraud, government has come across many fraud settlements over the years and has paid big payments who had sued on behalf of the government. This law applies in situations like double billing by providers, refusing to provide medically necessary care etc. A number of federal and state statutes are dealt by the Government in regard to the Medicare fraudulent.

The government provides the prosecutor with many options related to health care. Following is a list of possible criminal prosecution: A False Claims act is a government statute under which, any health care provider who presents a false claim or demand regarding any medical services can be held guilty. The prosecutor needs to prove that the provider intentionally false claimed. A False Statement Act imposes liability on a provider if in a communication submitted to the government had false writings or documents.

In such a violation the government only needs to prove that the provider knowingly submitted the statement or documents knowing they were false. Anti-kickback act concerns individuals and entities that knowingly make false statements in applying for payments provided by the government and states regarding health care. It also prohibits individuals concealing information of events that claim their