Which established the CERT fathom Hpmp pepper and perm programs?

Which established the CERT fathom Hpmp pepper and perm programs?

Stack #552582

Question	Answer
Responsible for initially requesting and screening medical records for PEPP surveillance sampling for medical review.	Clinical Data Abstracting Centers
established PERM, CERT, HPMP, FATHOM, and PEPPER.	Improper Payments Information Act of 2002

What agency of the federal government usually investigates hospital False Claims Act cases?

Office of Inspector General What agency usually investigates hospital False Claims Act cases? trying to enforce the federal False Claims Act.

What does the federal False Claims Act forbid quizlet?

Imposes liability on any person who submits a claim to the federal government that he or she knows (or should know) is false.

Which measures improper payments in the Medicaid program and the State Children’s Health Insurance Program Schip )?

The PERM program measures improper payments in Medicaid and CHIP and produces improper payment rates for each program.

Which legislation protects and compensates railroad workers?

The Federal Employers Liability Act, also known as FELA, is a federal law enacted in 1908, that protects and compensates railroad workers – including BMWED members – that are injured on the job. FELA is essentially the form of Workers’ Compensation in the railroad industry.

Which of these is a court issued document ordering patient records required for a medical lawsuit?

This is sometimes also referred to as “general consent.” This consent is sufficient for common or simple procedures with little risk (such as when a patient schedules and keeps a medical appointment).

Who does Stark Law apply to?

The Stark statute applies only to physicians who refer Medicare and Medicaid patients for designated health services to entities with which they (or an immediate family member) have a financial relationship. There are almost 20 exceptions to the Stark statute.

What is the Stark Law in healthcare?

This statute prevents fraudulent and unnecessary testing, referrals, and medical services. Additionally, it prevents physicians from seeking further personal financial or equity gains regarding patient care which is a clear conflict of interest. These limitations impact clinical decision-making and healthcare delivery.

What is the federal False Claim Act?

In sum, the False Claims Act imposes liability on any person who submits a claim to the federal government that he or she knows (or should know) is false. An example may be a physician who submits a bill to Medicare for medical services she knows she has not provided.

What is Qui Tam law?

Definition. In a qui tam action, a private party called a relator brings an action on the government’s behalf. The government, not the relator, is considered the real plaintiff. For example, the federal False Claims Act authorizes qui tam actions against parties who have defrauded the federal government.

What is not a responsibility of a Zone Program Integrity Contractor?

ZPICs do not handle complaints, audit cost reports, or process claims. All medical and documentation review is specifically for the purpose of verifying benefit integrity.

What is the Federal Railroad Safety Act?

On August 3, 2007, the Federal Railroad Safety Act (FRSA), 49 U.S.C. Under FRSA, an employee of a railroad carrier or a contractor or subcontractor (such as a manufacturer or repairer of operational equipment for a railroad carrier) is protected from retaliation for reporting certain safety and security violations.

Who is responsible for contract disputes in the federal government?

In addition, the Government Accountability Office Contract Appeals Board handles contract disputes arising in the legislative branch, and the Office of Dispute Resolution for Acquisition handles contract disputes and bid protests arising out of Federal Aviation Administration procurements. What Types of Claims Are Subject to the CDA?

Can a government claim be brought against a contractor?

Claims by the government, such as claims for liquidated damages or claims for default termination, are subject to the CDA and may be brought by the government against a contractor after a contracting officer has issued a final decision on each claim.

What makes a claim under the Contract Disputes Act?

First, a contractor must make a written demand or assertion. A mere notification by a contractor notifying a contracting officer of an issue or an amount the contractor believes it is entitled to does constitute a claim under the CDA.

When does the Contracting Officer issue a final decision?

If the contractor’s claim is for an amount less than $100,000.00, the contracting officer must issue a final decision within sixty (60) days of receipt of the claim.