Legal Aspects of Health Care Reimbursement

Legal Aspects of Health Care Reimbursement

Paperback

$31.46 $34.95 Save 10% Current price is $31.46, Original price is $34.95. You Save 10%.
View All Available Formats & Editions
Use Standard Shipping. For guaranteed delivery by December 24, use Express or Expedited Shipping.

Product Details

ISBN-13: 9781587980930
Publisher: Beard Books, Incorporated
Publication date: 03/28/2001
Pages: 304
Product dimensions: 5.92(w) x 8.94(h) x 0.83(d)

Table of Contents

Acknowledgmentsix
Chapter 1Introduction: The Legal System1
Sources of Law1
Major Areas of the Law3
The Federal-State Dichotomy4
Medicare and Medicaid Laws6
Administrative and Court Procedures Affecting Medicare and Medicaid11
Part IThe Medicare Program17
Chapter 2Medicare: Inpatient Hospital Reimbursement23
The Acute Care Hospital23
Cost Containment29
Reimbursement Based on DRGs31
Capital-Related Costs36
Labor/Delivery Room Days45
Hill-Burton49
TEFRA54
Outlook55
Chapter 3Medicare: Long-Term Care63
Skilled Nursing Facility63
Medicare Reimbursement Law67
Capital-Related Costs70
Related Organization Principles78
Outlook83
Chapter 4Medicare: Hospice Care87
Hospice Coverage87
Conditions of Participation88
Reimbursement Legislation90
Reimbursement Regulations91
Outlook96
Chapter 5Medicare: End-Stage Renal Disease101
ESRD Medicare Program101
Conditions of Participation103
Reimbursement Legislation107
Reimbursement Regulations108
Outlook113
Chapter 6Fraud and Abuse in Medicare123
Statutes123
Regulations126
Cases131
Outlook133
Part IIThe Medicaid Program137
Chapter 7Medicaid: Inpatient Hospital Reimbursement147
Legislative History of Medicaid Reimbursement147
Federal Regulations148
State Reimbursement Policies149
Reasonable and Adequate Litigation153
Limits to Paid Care159
State Reimbursement Methodologies162
Outlook179
Chapter 8Medicaid: Long-Term Care Reimbursement185
The Skilled Nursing Facility185
The Intermediate Care Facility186
Medicaid Reimbursement Law189
Medicaid Reimbursement Policies198
Property Cost Containment204
Reimbursement Factors212
Family Responsibility and Long-Term Care221
Outlook228
Chapter 9Abortion and Family Planning Services237
U.S. Supreme Court Cases237
Legislative Restrictions240
Regulations242
Litigation243
Sterilization247
Outlook249
Chapter 10Fraud and Abuse in Medicaid253
Statutes253
Regulations255
Cases263
Outlook269
Epilogue273
Table of Cases279
Index283

Customer Reviews

Most Helpful Customer Reviews

See All Customer Reviews