Ofesi ya Inspector General (OIG) inapanga ndi kupereka zidziwitso zachinyengo kwa anthu odwala. Zochenjeza izi zinali zoti zidziwitse mtundu wachinyengo kwa anthu onse. Imeneyi ndi njira yowunikira komanso kuzindikira za njira zachinyengo m'makampani ophwanya malamulo komanso madandaulo okhudza Medicare ndi Medicaid Anti-Kickback Law.
Medicare ndi Medicaid Law Anti-Kickback Law
Lamulo loletsa anti-Kickback limapereka chidziwitso chozindikiritsa ndi kulanga munthu wina aliyense kuti apewe zosankha zina zaumoyo pogwiritsa ntchito ndalama. Zakudyazo ndizitali koma zimagwera m'magulu awiri:
- Ndalama iliyonse yamalonda yomwe imakhudza kutumiza munthu pa ntchito iliyonse yomwe imaperekedwa pansi pa pulogalamu ya Medicare kapena Medicaid
- Ndalama iliyonse ya ndalama yomwe imatsogolera kugulidwa kwa chinthu chilichonse chomwe chimalipira pulogalamu ya Medicare kapena Medicaid
Zolango zotsutsana ndi lamulo la Anti-Kickback zingakhale zovuta. Kuphwanya lamulo la Anti-Kickback ndi chigamulo cha federal chomwe chingabweretse ndalama zokwana madola 25,000 pa kuphwanya ndi / kapena kundende zaka zisanu. Kuphatikiza pa malipiro ndi ndende, ogwira ntchito angathenso kupezeka nawo pa Gawo la Federal Healthcare Program. Pomwe wina wothandizira asatenge nawo mbali mu Federal Healthcare Program, wothandizira sangathe kulandira malipiro a mautumiki aliwonse opangidwa kapena zinthu zoperekedwa kwa odwala.
Izi zikuphatikizapo mautumiki opangidwa kapena zinthu zomwe zimaperekedwa ku malangizo kapena mankhwala a munthu wosapatsidwa.
Zolakwa Zapadera zachinyengo
OIG adatchula madera asanu omwe angasonyeze kuphwanya malamulo otsutsa-kickback. Sitikufuna cholinga china chilichonse kusiyana ndi kuzindikira ntchito zomwe zingakhale zabodza.
- Mikangano Yothandizana Nawo: Kuphatikizana kulikonse komwe kwakhazikitsidwa kuti pakhale mtsinje wa kutumizidwa kuchokera kwa amalonda a madokotala omwe amalipiritsa mwachindunji kungakhale kokayikitsa. Dokotala aliyense yemwe amapindula ndi ndalama kuchokera ku kutumiza angayambe kapena kuchita ntchito zosafunikira zimene zimapindulitsa ku mapulogalamu a Medicare ndi Medicaid.
- Kukhometsa ndalama kapena Deductibles: Kumangopereka ndalama zothandizira odwala kapena kupereka madokotala kwa Medicare popanda kuwonetsa mavuto a zachuma chifukwa chogwiritsa ntchito kwambiri mankhwala omwe Medicare amapereka. Wothandizira angapangitse odwala kuti alowe muzinthu kapena ntchito zomwe sizili zofunikira kuchipatala. Odwala ndi okonzeka kutsatira chifukwa chakuti zinthu ndi ntchito zili mfulu.
- Madandaulo a Chipatala kwa Madokotala: Mu mafakitale omwe akukula mofulumira, madokotala akhoza kukhala ovuta kulandira ndi kusunga. Mazipatala omwe amakopeka madokotala ndi zolimbikitsa zapadera zimatanthauza kuti dokotala amatumiza odwala ake onse kwa iwo. Chisankho ichi chikanakhazikitsidwa ndi mphamvu zachuma kusiyana ndi khalidwe la chisamaliro.
- Kugwiritsa Ntchito Mankhwala Osokoneza Bongo: Madokotala kapena madokotala akulandira mphatso kapena malipiro posinthanitsa ndi odwala awo omwe ali ndi mankhwala osokoneza bongo akuwopsa. Malipiro operekedwa kwa odwala chifukwa chosintha mankhwala kuchokera ku chinthu china kupita ku chimanso ndi chizindikiro cha khalidwe loopsa.
- Mapulogalamu a Zipatala: Nthawi zina, ma laboratory angapereke madokotala, zipatala kapena ntchito zina zapadera kunja kwa momwe akuyembekezera nthawi zonse kapena zoyembekezera. Ikhoza kuwonedwa ngati yopindulitsa popititsa kukalembera ku labotore.
Kufotokozera Information
Pofuna kuthandizira kuchepetsa chinyengo, OIG amapempha kuti mutumizire Dipatimenti ya Zaumoyo ndi Zaumuna kapena Ofesi ya Inspector General kuti mudziwe zambiri zomwe mungakhale nazo ponena za aliyense amene ali ndi chithandizo chamankhwala choletsedwa.
Zotsatira:
Brown, June Gibbs. Inspector General Notice. Ofesi ya Inspector General. Dipatimenti ya Zaumoyo ya Ukhondo ku United States. Tsiku December 2, 1994, www.oig.hhs.gov.