HIPAA

Fraud and Abuse — Inspector General’s Counsel Responds and AAPS Replies

Author: 
D. McCarty Thornton, Jane M. Orient, MD
Article Type: 
Editorial
Issue: 
September/October 1998
Volume Number: 
3
Issue Number: 
5

Dear Dr. Orient:

Medical Necessity Under Kassebaum-Kennedy

Author: 
Lawrence R. Huntoon, MD, PhD
Article Type: 
Medical Ethics and Managed Care
Issue: 
July/August 1998
Volume Number: 
3
Issue Number: 
4

They're federal agents...they're coming through the front door of YOUR office to conduct a Medicare investigation...their guns are drawn and they're pointed in YOUR direction. Tiny little beads of sweat start to form on your forehead as you peer down the barrel of the agent's gun, anxiously waiting for what comes next. Make my day? Nope. A riddle: What's vague, undefined and can hurt you...a lot? Answer: "Medical Necessity."(1)