1) The document discusses patient neglect and Medicaid fraud, providing contact information for reporting concerns about neglect by caregivers or fraud by medical providers.
2) It defines patient neglect as knowingly failing to provide necessary treatment or care, resulting in injury, and lists indicators such as malnutrition, untreated bedsores, or failure to follow medical orders.
3) Medicaid fraud by providers is described as billing for unnecessary or more expensive services than provided, or billing multiple times for the same service.
1) The document discusses patient neglect and Medicaid fraud, providing contact information for reporting concerns about neglect by caregivers or fraud by medical providers.
2) It defines patient neglect as knowingly failing to provide necessary treatment or care, resulting in injury, and lists indicators such as malnutrition, untreated bedsores, or failure to follow medical orders.
3) Medicaid fraud by providers is described as billing for unnecessary or more expensive services than provided, or billing multiple times for the same service.
Direitos autorais:
Attribution Non-Commercial (BY-NC)
Formatos disponíveis
Baixe no formato PDF, TXT ou leia online no Scribd
1) The document discusses patient neglect and Medicaid fraud, providing contact information for reporting concerns about neglect by caregivers or fraud by medical providers.
2) It defines patient neglect as knowingly failing to provide necessary treatment or care, resulting in injury, and lists indicators such as malnutrition, untreated bedsores, or failure to follow medical orders.
3) Medicaid fraud by providers is described as billing for unnecessary or more expensive services than provided, or billing multiple times for the same service.
Direitos autorais:
Attribution Non-Commercial (BY-NC)
Formatos disponíveis
Baixe no formato PDF, TXT ou leia online no Scribd
PATIENT NEGLECT being committed by a provider, or a care
As the elderly or disabled dependent person you know is suffering become more and more from patient neglect, write or call: dependent on others for their care, it becomes increasingly important for Office of Attorney General individuals who accept Medicaid Fraud Control Unit the position of trust as 1600 Strawberry Square caretakers of these Harrisburg, PA 17120 vulnerable people to be 717-783-1481 held accountable for neglecting those in their care. Failure to provide the care and treatment Office of Attorney General necessary to maintain the welfare of those who Medicaid Fraud Control Unit depend on that care is every bit as dangerous and 10950 Route 30 harmful as intentional assaultive behavior. North Huntingdon, PA 15642 Criminal neglect of a care dependent person occurs 724-861-3670 when a caregiver knowingly, intentionally or recklessly fails to provide treatment, care, goods, Office of Attorney General or service that is necessary to maintain the health Medicaid Fraud Control Unit or safety of the care dependent person. The failure 106 Lowther Street must then result in bodily injury to the care Lemoyne, PA 17043 dependent person. 717-712-1220 Office of Attorney General INDICATORS OF PATIENT NEGLECT Medicaid Fraud Control Unit Care dependent persons who are malnourished, 1000 Madison Avenue dehydrated, or have untreated bedsores. Norristown, PA 19403 610-631-5920 Staff failing to follow doctors’ orders with regard to treatment of a care dependent person. www.attorneygeneral.gov Failure to seek needed medical treatment for a care dependent person in a timely manner or not at all. Care dependent persons who appear unkempt, unclean, or disheveled. In 1978, the MEDICAID FRAUD Pennsylvania The Medicaid Fraud Control Unit investigates Giving or accepting something of value in return PROVIDER FRAUD. A provider is any business for providing medical services, i.e. kickbacks. Office of Attorney or individual that supplies health care goods and General created a Providing medically unnecessary services. services to Medicaid recipients. Providers can be Medicaid Fraud medical doctors, dentists, hospitals, nursing homes, Falsifying cost reports. Control Unit whose pharmacies, durable medical equipment sellers, Billing for ambulance runs to doctor purpose was to ambulance companies, or anyone else who bills the appointments. investigate and Medicaid Program for health care goods and services provided to a Medicaid recipient. A provider commits In many areas of the Commonwealth, Health prosecute fraud fraud by giving false information regarding services Maintenance Organizations (HMO’s) have contracted committed by medical providers rendered to Medicaid recipients. The result is an with the Department of Public Welfare to administer enrolled in the Medicaid program, as increase in the cost of the Medicaid program, which the Medicaid funded medical services. well as to investigate patient abuse and eventually will be passed along to the taxpayers. neglect in Medicaid funded health care facilities pursuant to the Medicare- EXAMPLES OF MEDICAID FRAUD HEALTH MAINTENANCE Medicaid Anti-Fraud and Abuse Billing for medical services not actually ORGANIZATIONS (HMO’s) Amendment of 1977. performed. Although HMO’s can be defrauded by providers in ways similar to the fraud committed in the traditional Billing for a more expensive service than fee-for-service setting, HMO’s present unique fraud The unit is a part of the Office of was actually rendered. issues. Whereas in standard health care Attorney General’s Criminal Law Billing for separate services that should be reimbursement situations the fraud is characterized Division and is comprised of combined into one billing. by overbilling, an HMO environment creates an prosecutors, agents and auditors incentive to deny care to patients/consumers. This Billing twice for the same medical service. housed in three regional offices across means that while a fee has been paid by the HMO to the Commonwealth. The Medicaid Dispensing generic drugs and billing the provider for covered services, the services are for brand-name drugs. denied or cut back for other than sound medical Fraud Control Unit has the authority to reasons. This not only defrauds the insurance file felony and misdemeanor charges company, but also compromises patient health. against those who defraud the Medicaid program or commit patient neglect.