Fraud & Abuse

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2008 Master Medicare GuideThe 2008 Master Medicare Guide features explanatory material related to Medicare reimbursement and compliance. Topics discussed include Medicare Part A, Part B, Part C and Part D Coverage, Program Agreements, Exclusions from Coverage, Medicare Reimbursements, Appeals, Compliance and Cost Reports.

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Topic Spotlight

CMS revises reimbursement determination appeal procedures

Various provisions governing Medicare Part A provider reimbursement determinations, appeals before the intermediary hearing officers and the Provider Reimbursement Review Board (PRRB), and CMS Administrator review of PRRB decisions will become effective August 21, 2008, under a Final rule published by CMS on May 23, 2008.

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In Focus

Health Care Compliance Letter

Experts advise on community benefit, Form 990 challenges
by Larry Perlman, C.P.A., J.D., LL.M., Contributing Editor

Journal of Healthcare Compliance

What Would Compliance Professionals Find if They Were Dropped into a "Man vs. Wild" Situation?
by Roy Snell, Chief Executive Officer/Executive Director of the Health Care Compliance Association

Institutional Review Boards: Current Compliance Trends and Emerging Models
by Winifred Ann Meeker-O’Connell

Greg Luce Talks about the Relationship between Legal Counsel and Compliance
by Roy Snell, Chief Executive Officer/Executive Director of the Health Care Compliance Association

Health Care Compliance Professional’s Manual

Interacting with Pharmaceutical Representatives
by Teresa Bivens, CPC, CHC

CMS Program Integrity Group’s Compliance Initiatives
by Lisa Eggleston

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