(ZPICS), (RAC) and Healthcare Fraud Waste and Abuse Research Paper

(ZPICS), (RAC) and Healthcare Fraud Waste and Abuse - Research Paper Example Fundamentally, the practice of auditing started with the concept of oversight in which conventional Medicare auditing commenced with the practice of peer review organizations, commonly known as quality improvement organizations (QIOs) as was formerly established in 1982; and this program was designed to improve both efficiency and quality of Medicare services to the relevant patients; after this enactment, four major areas of Medicare were chosen for the purpose of scrutiny: care transitions, beneficiary protection, prevention and patient safety ((Blumen and Lenderman, 2010). the important legislation in the form of Medicare Modernization Act (MMA) was signed by George W. Bush on December 8, 2003 (About CMS, n.d.). In the following parts of this paper, first, background information has been provided in which basic information about healthcare system, fraud and abuse definitions have been given. It is followed by development segment in which more detailed view of the ZPICS and RACS ha ve been included. Subsequent to that, the HEAT uses have been elaborated in which examples pertaining to HEAT program and efficiency for delivering or satisfying the ultimate objectives of CMS. After this segment, impact section has been included in which the practical effort of these programs on the ground practices has been detailed. Before the summary part, strengths and weaknesses of these programs with regard to fraud, abuse and waste have been elucidated.

International Law Essay Example | Topics and Well Written Essays - 1250 words

What International Law Is - Essay Example In an interesting twist of paradox, despite the pervasive and dynamic nature of international law, there has never been any lawmaking organ for the same. On the contrary, international law is a culmination of international accords, compromises, charters, conventions, agreements, protocols, memoranda, tribunals, and treaties. The history of international law can be traced as far back as 1815 when Austria’s prince Klemens W. von Metternich led other leading diplomats such as France’s Prince Talleyrand, Britain’s Duke of Wellington, Russia’s Tsar Alexander I, and Prussia’s King Frederick William into the Metternich System. This congressional approach to diplomacy is alternatively known as the Concert of Europe or the Congress System. From this development, international relations is seen to have developed, as Britain, Russia, Prussia, France and other players met in succeeding convents in the Congress of Vienna and Aix la Chappelle (1818). Imperialism and the quest to garner as many colonies as possible created the need to meet and draw out laws that would regulate how states related, even as they clamored for colonies. It is at this point that colonies’ and protectorates’ geopolitical boundaries were mapped out during the 1884-5 Berlin Conference to stave off the possibility of war in Europe over colonies. In this conference, the frameworks for public international law were laid, albeit in a remote sense. The League of Nations also served as a rallying point for international law, as states came together under its auspices to prevent a repeat of World War I. Of particular importance is Woodrow Wilson’s Fourteen Points, which strongly laid foundation for international trade, diplomacy, territorial integrity (in relation to the sea, land, and air), and human rights and freedoms among other principles. Although Wilson’s proposals were not adopted fully, one can see that they greatly upheld public and pri vate international law. As time proved the goals of the League of Nations untenable, the United Nations came up on June 26th, 1945, to facilitate international law, security, and socio-economic development. Over time, the United Nations has come to be the key platform upon which international law and diplomacy are deliberated, entrenched, and ratified. The UN has mechanisms that deal with thematic issues such as treaties, the law of seas, progressive development, and codification of international law and the internal justice system of the UN. Likewise, the UN has international courts and tribunals, legal training, resources, centers, and UN bodies to preside over international legal matters. Some of these bodies include the International Law Commission, the General Assembly Sixth Committee, and the UN Commission on International Trade Law (Rabkin, 2005). Together with sovereign states, all these organs play a crucial role in the generation of international law. Substantive differenc es between municipal (domestic) and international law abound. While municipal law governs intra-state relations, international law does inter-state relations. Secondly, the principal goal of municipal law is to ensure the existence of judicial and legislative systems that can enforce laws and  settle disputes effectively, on the one hand.