Legal Aspects of Health Care ReimbursementLegal Aspects of Health Care Reimbursement, written in 1985, presents a historical perspective of reimbursement legislation and regulations with regard to several important aspects of Medicare and Medicaid claims, which have a great potential for fraud and abuse. Focus is on penalties and offenses. Part I deals with Medicare. Several well-documented chapters are dedicated to long-term care, inpatient hospital reimbursement, hospice care, and end-stage renal disease. Part II, deals with Medicaid. In addition to inpatient hospital reimbursement and long-term care, there is an informative expose of abortion and family planning services, to include U.S. Supreme Court cases, legislative restrictions, regulations, and litigation. Each chapter concludes with an "Outlook" section that suggests ways of containing inequities, limiting costs or improving flawed procedures. This impeccably researched study is valuable reading not only for lawyers and health care administrators, but for all health care professionals. Book jacket. |
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Page 45
... average per diem cost of general routine care is calculated , even if these patients have not yet received routine care . This average per diem cost is equal to the annual cost of routine services divided by the total number of ...
... average per diem cost of general routine care is calculated , even if these patients have not yet received routine care . This average per diem cost is equal to the annual cost of routine services divided by the total number of ...
Page 104
... average of 4.5 dialyses per week to achieve unconditional status . The same center or facility is given conditional status if it has 6 or more dialysis stations with each performing an average of 4 to 4.5 dialyses per week , or 4 or 5 ...
... average of 4.5 dialyses per week to achieve unconditional status . The same center or facility is given conditional status if it has 6 or more dialysis stations with each performing an average of 4 to 4.5 dialyses per week , or 4 or 5 ...
Page 199
... Average Per Average Per Method Diem Payment ( 1984 ) ( 1983 ) Method ( 1984 ) Diem Payment ( 1983 ) Alabama Alaska 1 $ 32.34 $ 32.34 Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana ...
... Average Per Average Per Method Diem Payment ( 1984 ) ( 1983 ) Method ( 1984 ) Diem Payment ( 1983 ) Alabama Alaska 1 $ 32.34 $ 32.34 Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana ...
Contents
PART | 17 |
Inpatient Hospital Reimbursement | 23 |
LongTerm Care | 63 |
Copyright | |
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Legal Aspects of Health Care Reimbursement Robert J. Buchanan,Buchanan and Minor,James D. Minor Limited preview - 2001 |
Common terms and phrases
abortions according addition adequate adjusted administrative agency allowable Amendment amount appeals applied approved assets Association authority average basis benefits calculated capital changes charges concluded Congress considered continuous cost Court of Appeals covered decision Department depreciation determine developed directed district court effective efficient ESRD established expenses facility federal Federal regulations final Financing Fiscal funds HCFA home dialysis hospital implementation increase individual inpatient interest issue legislative limit Medicaid Guide Medicaid program Medicare and Medicaid Medicare patients Medicare reimbursement meet method Michigan necessary needs nursing home operating paid participation party patients payment percent period physician plaintiffs procedures prospective provider purchase reasonable reasonable cost receive regulations reports responsible result return on equity routine secretary Social Security standard statute supra treatment United violations