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A Joint Project Between the OIG and DOJ
By Patricia Trites; MPA, CHBC, CPC
The Healthcare Fraud and Abuse Control (HCFAC) program is a joint project between the Office of Inspector General [OIG] and the Department of Justice (DOJ).
Functions
The primary functions are to coordinate federal, state, and local enforcement in controlling healthcare fraud, and to conduct investigations relating to delivery and payment of healthcare services, and oversee Medicare and Medicaid exclusions, civil money penalties, and the anti-kickback law. The program is also designed to provide opinions, alerts, and a means for reporting and disclosing final adverse actions against healthcare providers.
HIPAA Policies
HIPAA established the Health Care Fraud and Abuse Control Account within the Medicare Part A Trust Fund and funds DOJ and DHHS activities for operation of the HCFAC. In addition to federal appropriations, the fund receives a portion of funds collected from healthcare fraud and abuse penalties and fines. HIPAA also authorizes funds from general revenues for the Federal Bureau of Investigation (FBI) to combat healthcare fraud and abuse.
Assessment
Anti-fraud and abuse provisions were also included in the Balanced Budget Act of 1997 and the Deficit Reduction Act [DRA] of 2005, and annotated and
Conclusion
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Filed under: Career Development, Health Law & Policy, Healthcare Finance, Professional Liability | Tagged: anti-kickback, BBA, david marcinko, DOJ, DRA, FBi, HCFAC, healthcare abuse, healthcare fraud, HIPAA, Medicaid, medicare, OIG, Patricia Trites, Stark, www.healthcarefinancials.com | 17 Comments »
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