Healthcare Fraud
Health Care Fraud
1. Types of Health Care Fraud
A. Health insurance
B. Drug Fraud
C. Punishment
2. Entities involved in Health care fraud
A. Social
a. Individuals
B. Political
a. Oversight
b. Supreme Court input
C. Cultural
3. Technology and health Care Fraud
A. Billing Procedures
B. Unbundling
4. Ethics involved with Fraud/Economic Impact
a. Effects on Health Care
b. Monitor outgoing monies
5. Strategies to resolve current Health Care Fraud issues
a. Combatting Medical Care Fraud
6. Conclusion
7. References
In the United States there are many different types of coverages available for individuals and hospital plans needing insurance coverage. While this can be of great assistance for those suffering from different injuries and ailments, it can also give birth to a vast number of methods to commit torts against the Government, Insurance companies, Health care providers and of course the individual tax payer.
Individuals who feel they are giving or receiving the proper amount for services rendered have come to notice that they have actually become victims of criminal forces. In the following paragraphs I will describe the different units of health care fraud, the effects of health care fraud along with what entities are involved as well as technology and ethics and finish with some strategies to combat health care fraud.
With health care fraud, we must consider this: “There's a group of people who really love the U.S. health care system -- the fraudsters, scammers and organized criminal gangs who are bilking the system of as much as $100 billion a year.” (Kavilanz, January) Some other information in my research stated that almost $50 billion were distributed in doubtful Medicare payments.
One way a criminal can defraud the Medicare system is called the Pay and Chase method. This is due to the fact that
1. Types of Health Care Fraud
A. Health insurance
B. Drug Fraud
C. Punishment
2. Entities involved in Health care fraud
A. Social
a. Individuals
B. Political
a. Oversight
b. Supreme Court input
C. Cultural
3. Technology and health Care Fraud
A. Billing Procedures
B. Unbundling
4. Ethics involved with Fraud/Economic Impact
a. Effects on Health Care
b. Monitor outgoing monies
5. Strategies to resolve current Health Care Fraud issues
a. Combatting Medical Care Fraud
6. Conclusion
7. References
In the United States there are many different types of coverages available for individuals and hospital plans needing insurance coverage. While this can be of great assistance for those suffering from different injuries and ailments, it can also give birth to a vast number of methods to commit torts against the Government, Insurance companies, Health care providers and of course the individual tax payer.
Individuals who feel they are giving or receiving the proper amount for services rendered have come to notice that they have actually become victims of criminal forces. In the following paragraphs I will describe the different units of health care fraud, the effects of health care fraud along with what entities are involved as well as technology and ethics and finish with some strategies to combat health care fraud.
With health care fraud, we must consider this: “There's a group of people who really love the U.S. health care system -- the fraudsters, scammers and organized criminal gangs who are bilking the system of as much as $100 billion a year.” (Kavilanz, January) Some other information in my research stated that almost $50 billion were distributed in doubtful Medicare payments.
One way a criminal can defraud the Medicare system is called the Pay and Chase method. This is due to the fact that