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Healthcare Fraud: A Primer for the Nurse Executive

Cady, Rebecca F. RNC, BSN, JD

JONA's Healthcare Law, Ethics, and Regulation: April-June 2007 - Volume 9 - Issue 2 - p 54-61
doi: 10.1097/01.NHL.0000277202.16864.aa
ARTICLES

Healthcare fraud has become an issue about which all healthcare providers must be aware. Unfortunately, for most of us, the laws and the regulations developed to enforce the laws regarding fraud in healthcare are among the most confusing ever written. Healthcare fraud is an important area of risk for the nurse executive and an area about which all nurse executives need to be aware. Healthcare fraud primarily relates to improper billing of governmental healthcare programs. A basic understanding of these programs is therefore fundamental to understanding the problem of healthcare fraud and how to prevent it. This article will provide a basic overview of this subject for the nurse executive.

Corresponding author: Rebecca F. Cady, RNC, BSN, JD, Partner Grace Hollis Lowe Hanson & Schaeffer LLP, Visalia, CA 93291 (e-mail: rcady@gracehollis.com).

© 2007 Lippincott Williams & Wilkins, Inc.