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The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
Overbilling is a part of many fraud audit infrastructures employed by large companies. [12] Computer programs and software is often used to screen a company's finances to check for overbilling or symptoms of overbilling. [13] Overbilling has been the focus of several infamous scandals, such as the Worldcom scandal [14] and the bankruptcy of W ...
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4]
Aug. 28—A company that provides oxygen equipment agreed to a $29 million settlement to resolve claims, brought by whistleblowers, that they were overbilling Medicare.
Reporting can be conducted online, [3] by phone, or by submitting the MedWatch 3500 form by mail or fax. In 2013, MedWatch introduced Form 3500B, which is designed to facilitate reporting by healthcare consumers. [4] The MedWatch system is intended to detect safety hazard signals for medical products. If a signal is detected, the FDA can issue ...
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The medical record serves as the central repository for planning patient care and documenting communication among patient and health care provider and professionals contributing to the patient's care. An increasing purpose of the medical record is to ensure documentation of compliance with institutional, professional or governmental regulation.
Case report forms contain data obtained during the patient's participation in the clinical trial. Before being sent to the sponsor, this data is usually de-identified (not traceable to the patient) by removing the patient's name, medical record number, etc., and giving the patient a unique study number.