organization that the physician or a member of his/her immediate family has a financial relationship. Exceptions to the law exist and will be examined in later sections of this reflection. Originally the Stark Law (Stark I) only applied to referrals of Medicare Beneficiaries‚ but Section 1877 of the Social Security Act (the Act) (42 U.S.C. 1395nn)‚ also known as the physician self-referral law‚ or Stark Law‚ intends to prevent the misappropriation of or over utilization of healthcare that could result
Premium Health care Medicare Medicine
ignorance or reckless disregard to the truth. Civil penalties for false claims are up to $11‚000 for each false claim‚ plus three times the amont of damages the government sustains from each claim. Violation may also lead to exclusion from Medicare and Medicaid (or other Federal health care programs). Damages may be brought by private persons‚ competitors or employees of a provider on behalf of the government. Private persons are entitled to a percentage of the monies
Premium Medicare Medicine Health care
meant for the time when treatment can no longer help‚ and there is no expectation of recovery. The focus of Hospice is pain and symptom management as well as support services providing counseling and education to the patient and family. Medicare‚ Medicaid‚ and most private insurance plans pay for services that Home Health Care Agencies provide. Payment from these sources depends on whether the care is medically necessary and the individual meets specific coverage criteria. Individuals may opt
Premium Nursing home Medicine Home care
healthcare or aging into it. They had imagined life without ill-health‚ and living self-sufficiently in their own home. Their imagined-future had been dashed and they became helpless. They now have to pay with self-funding‚ relying on family members‚ Medicaid and veteran’s benefits. Don and Mary could have planned ahead for possible long-term care cost while they were still very much active. Having learnt some hard lessons from the lives of Don and Mary‚ my plan in preparing for the possibility of needing
Premium Nursing home Activities of daily living Geriatrics
Introduction Home Health Aides(HHA) are healthcare professionals‚ who visit the homes of the ill‚ disabled‚ elderly‚ socially disadvantaged who are unable to perform basic tasks and so HHAs provide a wide spectrum of personal and home making assistance. The people who receive care usually need help with basic daily tasks such as meal preparation‚ medication reminders‚ laundry‚ light housekeeping‚ errands‚ shopping‚ transportation‚ and companionship (Wikipedia‚ 2007). There are several different
Premium Home care Health care Hand sanitizer
Pauline Vaillancourt Rosenau with the assistance of Paul Newhouse Management ‚ Policy‚ and Community Health School of Public Health University of Texas Health Science Center Houston‚ Texas‚ USA I. Types of post-acute‚ institutional‚ residential‚ and community-based settings for older adults II. Types of clients served in select settings III. Facility and patient demographics IV. Payment and cost of long-term care V. Community Living Assistance Services and Supports program (CLASS Act)
Premium Nursing home Geriatrics Activities of daily living
Omnibus Budget Reconciliation Act (OBRA) of 1987; established regulations for nursing homes receiving federal funding that includes reimbursements from Medicare or Medicaid programs. It was signed by President Ronald Reagan‚ and it was the first major revision to the federal standards for nursing home care since the creation of both Medicare and Medicaid in 1965. This legislation changed the legal expectations of nursing homes and their care. If nursing homes do not comply with these regulations they
Premium Nursing home Nursing Medicare and Medicaid
The Continuum of Long-Term Health Care Lisa Lewis HCS/310 August 9‚ 2010 John Dean The Continuum of Long-Term Health Care Health care is a fascinating industry. So many types of care are included within the industry. Health care can be very broad or very specific. Health care is also comprised of different types of health care. One specific sector is long-term health care. Long-term care plays a huge role in the health care continuum. This paper will define long-term care
Premium Nursing home Health care Medicare and Medicaid
Regulatory Agency Regulatory agencies are put in place to ensure that health care organizations and the providers within them promote safety‚ legal compliance‚ and quality care for patients. Regulating health care is vital because if health care organizations were not required to be accredited patients would not feel safe when seeking health care services. The Joint Commission on Accreditation of Healthcare Organizations otherwise known as JCAHO is a regulatory agency. The JCAHO “conducts periodic
Premium Health care Joint Commission International healthcare accreditation
Government Health Insurance Medicaid and Medicare HCS/531 03-16-2013 Dr. Dorothy Cucinelli Government Health insurance Medicaid and Medicare In today’s society concerning health care there are many aspects. These aspects are not limited to the provider‚ the patient‚ and the financial aspect. The aspect that is found quite interesting is the financial aspect. To be more specific about the financial aspect
Premium Health insurance Health economics Medicare