Vose varwere vane kodzero yekusarudza mutapi uyo anounza rubatsiro rwehutano kwavari. Izvi zvinowanzoreva mukutsvaga kwevarwere kubva kuchiremba uye zvipatara. Vanachiremba uye zvipatara zvinowanzoendesa varwere kune vanyengeri, kutarisira hutano pamusha, zvivako zvekugara kwenguva refu kana vamwe vashandi vezvoutano kuti vawedzere kutarisirwa kunze kweunyanzvi hwavo kana kukwanisa kuenderera mberi kwehanya.
Kazhinji chiremba kana hupatara hukama hunoputsa kodzero yevarwere yekusarudza mupi wekusarudza kwavo. Vanachiremba vanowanzobudisa nyaya kune mumwe chiremba anobva pane hukama kana humwe hukama. Zvipatara zvinowanzotumira kuendesa kune vanopa iyo ivo kana kuti vanobatana navo. Vose vanotarisira vanofanira kungwarira kuti varege kureva kana kupa kuti murwere haana chaanosarudza.
Kuti unzwisise zvizere varwere vakarurama vanofanira kusarudza vatsigiri, tarisa kune idzi zvitatu zvinobva:
- The Balanced Budget Act muna 1997: Sezvo chiitiko chekubatanidzwa muchirongwa chekuchengetedza hutano, zvipatara zvinofanirwa kugovera urongwa hwehutano hwemusha kune varwere vari munharaunda yeharaunda, vane Medicare-vakavimbiswa, vanoratidza kuti vakakumbira kuva iyo urongwa uye inoratidza kana chipatara ichifarira mari mune imwe sangano rehutano hwemusha.
- Dare: Dare rekutonga rakatarisa zvinotangira varwere vane utongi hwekurapa kwavo kusanganisira kodzero yekusarudza kana kutsanangura kuti ndiani anotarisira, zvisinei kuti ndiani ari kubhadhara kurapa.
- Federal Statutes: The Centers for Medicare neMedicaid zvirongwa zvakagadzirisa hurumende mitemo iyo varwere vane kodzero yekusarudza mupi wehanya kwavo pasinei nemamiriro ekurapa.
Kurwisana kwekodzero yevarwere yekusarudza mupi wekutarisira kwavo kunogona kutungamirira kurasikirwa nekodzero yekutora chikamu muMishonga yeMedare uye Medicaid .
Mitemo yeupfumi neyekushungurudza inorambidza vanachiremba, zvipatara, uye vamwe vanoita kuti vasavhiringidza kodzero yevarwere yekusarudza nekuita kuti zvibvumirwe kune avo vanoita kuti vawane chikonzero chekutumira uye kumanikidza murwere kuwana rubatsiro kubva kune mumwe munhu anopa. Vapiro vanokundikana kubvuma uye kuremekedza kodzero yevarwere yekusarudza kutyisa mitemo yehurumende uye yehurumende uye inofanira kutarisana nemigumisiro inobva muMutemo weAn anti-Kickback.
Mutemo weAn anti-Kickback unogadzirisa kutora uye kuvhara munhu upi zvake ane mhosva yekuita zvimwe zvido zveutano mukugadzirisa mari.
Zvigadziro zvakakura asi zvinowira mukati mezvikamu zviviri:
- Chero kushandiswa kwemari kunobatsira kutumirwa kweumwe munhu chero ipi zvayo inobhadharwa pasi pe Medicare kana Medicaid program
- Chero kushandiswa kwemari kunotungamirira kukutenga chero chinhu chipi zvacho chinotengwa pasi peMedareri kana Medicaid program
Nzvimbo nhatu dzemutemo weAnti-Kickback inotaura nezvechiremba uye zvipatara:
- Urongwa Hwokutaurirana Hwokutengeserana: Chero humwe hutano hwakabatana hwakagadzirirwa kuwana ruzivo rwekutumirwa kubva kune vashandi vezvechiremba umo vanobhadharwa nenzira isina kukodzera kunogona kuva mubvunzo. Cheropi chiremba anobhadhara mari kubva kune anotumira anogona kuronga kana kuita mabasa asina basa anokosha kumapurogiramu e Medicare uye Medicaid.
- Chipatara Chinokurudzira Vanachiremba: Munhizha inokura nokukurumidza, vanachiremba vanogona kuoma kuunganidza nekuchengetedza. Zvipatara izvo zvinoshandiswa pakukwezva vanachiremba nemakwikidziro chaiwo zvinoreva kuti chiremba anoendesa varwere vake vose kwavari. Ichi chisarudzo chichange chakavakirwa pamutungamiri wezvemari panzvimbo yehutano hwekutarisira.
- Clinical Lab Services: Mune zvimwe zviitiko, kunze kwebhakatoti rinogona kupa vanachiremba, zvipatara kana mamwe mabasa ehupi anonyanya kuisa kunze kwehuwandu hwemagariro avo kana zvibvumirano. Inogona kuonekwa semubatsiro mukutsinhana kwekutumira kune laboratory.