Identify the federal regulation or initiative used to combatfraud and abuse described in the following table. Refer to FederalRegulations and Initiatives segment of the chapter for additionalinformation.
| Example of fraud and abuse content to identify | List the regulation or initiative |
| These audits are patient care focused, such as reducingpressure ulcers | |
| Physician Self Referral Law | |
| Qui tam | |
| Implemented as per the Tax Relief and Health Care Act 2006 | |
| HEAT | |
| Prevent waste, fraud and abuse and reduce healthcare cost ispart of their mission | |
|
Physicians can’t receive money or other types of payment forreferring patients to a health facility |
|
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Organizations, individuals and entities can be penalized forunbundling, upcoding and other fraudulent coding practices underthis act |
|
| Office in the federal government that works to combat fraud,waste and abuse | |
| Reconsideration and appeals council are part of thisprocess | |
| Permits Medicare to refuse to allow convicted felons into theMedicare program |
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