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Financial Laws

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Financial Laws
Theodore Gladney
Health Services Finance
Professor: Alison Williams

Financial Laws

Five Elements Pertaining To the Establishment of a False Claim under the False Claims Act
The five elements necessary to establish a false claim must determine that the claim was in breach of State laws. It must be proved beyond reasonable doubt that the claim was false, fraudulent or fictitious and made for a monetary benefit. The false claim is established when an individual is in possession of a property or money used by the government with the intention to defraud the government (Boese, 2005). It must also be established that the ‘false claim’ was made with actual knowledge. False certification of receipt of property without attempting to confirm the truth of the information provided is also an element that constitutes false claim.
Three Broad Objectives of HIPAA Privacy Standards
HIPAA privacy standards aims to achieve the following three important objectives: i) Administrative Safeguards
HIPAA privacy rules designed procedures and policies regarding the administrative procedures of the act; how will the act be complied with.

ii) Physical Safeguards
HIPAA privacy rules were designed to control physical access to guard against inappropriate access to personal healthcare information.

iii) Technical Safeguards
HIPAA privacy rules control access to computer systems and facilitate enclosed entities to protect interactions involving PHI transmitted electronically over open networks from being intercepted by anyone other than the intended recipient.
10 specific Designated Health Services (DHS) for which referrals by physicians who have financial relationships with the entity providing the DHS are prohibited under Stark II Laws
As mentioned by Satiani (2006), following are the prohibited categories under Stark II: * Clinical laboratory

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