Preview

Health Care Fraud Research Paper

Satisfactory Essays
Open Document
Open Document
243 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Health Care Fraud Research Paper
Health Care Fraud can be very destructive, and has cost our country millions of dollars.With the FBI being the lead investigators of this type of destruction in our country as well as "having jurisdiction over both federal and private insurance programs." (Health Care Fraud Article). It is important for the public to be aware of what to look for when it comes to any type of fraudulent activity when dealing with one's health information, and what it is you need to do to protect yourself from being a victim of this type of fraud. If for any reason you feel like you are a victim of health care fraud then you should immediately get in contact with your health insurance company.

With charges being brought against two nurses as well as

You May Also Find These Documents Helpful

  • Powerful Essays

    Physicians are not allowed to refer patients to institutions, such as home-health providers, that they own a stake in ¡V should this law be extended to hospitals as well?…

    • 1172 Words
    • 5 Pages
    Powerful Essays
  • Good Essays

    There are joint efforts by several task forces like Health Insurance Portability and Accountability Act (HIPAA) and the Office of Attorney General (OIG), just to name two of them, that…

    • 485 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    (Price & Norris, 2009) The money lost due to fraud increases the costs of providing a full range of legitimate medical services tremendously. Physicians may perform unnecessary procedures to increase reimbursement, which may compromise the safety of the patient. Further, when medical providers bill for services that were never rendered, they end up creating a false medical history for patients which may hinder them from obtaining disability or life insurance policies, at a later date. An inaccurate medical history also influences treatment decisions and allows some third party insurance companies to deny coverage based on a previous medical condition. Health care fraud also tarnishes the reputation of the medical profession and other health care service providers. Additionally, the efforts by the federal and the state government cost taxpayers billions of dollars a year, thus diverting the scarce tax money from other essential services and meeting the needs of elderly and the poor. This diversion of the taxpayer’s money often results in reduced benefit coverage, changes in eligibility for programs such as Medicaid, higher premiums for individuals or their employers, or higher…

    • 1739 Words
    • 7 Pages
    Powerful Essays
  • Satisfactory Essays

    There are ten steps in the medical billing process This is pre-registering patients, establishing financial responsibility for the visit, checking in patients, checking out patients, reviewing coding compliance, checking billing compliance, prepare and transmit claim, monitoring payer adjucation, generating patient statements and doing follow up payments and collection.…

    • 355 Words
    • 2 Pages
    Satisfactory Essays
  • Powerful Essays

    Case Study for Fraud

    • 996 Words
    • 4 Pages

    The amount listed is the enrollment agreement was 10,020.00 which gives a difference of :…

    • 996 Words
    • 4 Pages
    Powerful Essays
  • Better Essays

    The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions…

    • 1070 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    The majority of health care fraud is committed by organized crime groups and a very…

    • 294 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    This is especially true when people file false claims or don’t realize that the poor outcome was directly related to the health issue that had already debilitated their health. The consumers need to be held accountable for their decisions and completely understand the risks and benefits of the health care they are receiving. This will come when people realize the importance of becoming their own advocate.…

    • 923 Words
    • 4 Pages
    Good Essays
  • Better Essays

    In 2012, the State of South Carolina spent $4.8 billion on the Medicaid program. At the end of that fiscal year, the US Department of Health and Human Services Office of Inspector General reported that nationwide only $1.4 billion had been recovered in fraudulent cases. “The US spends more than $2 trillion on healthcare annually. At least 3% of that spending-or $68 billion-is lost to fraud each year. Fraud accounts for 19 percent of the $600 billion to $800 billion in wasteful spending in the US healthcare system annually.” (Office of Inspector) No wonder our nation is in an economic breakdown in the health insurance market. The solution to Medicaid fraud may be as simple as spending more money on investigations and less time approving those who are just too lazy to work.…

    • 1756 Words
    • 5 Pages
    Better Essays
  • Satisfactory Essays

    Letter to Congress

    • 340 Words
    • 2 Pages

    As a Registered Nurse who has been employed at various managed care payers, I know firsthand the corruption and abuse that is typical of health insurance companies. It is political corruption that has allowed this situation to continue. Right now Congress and the President are fighting over how much to slash Medicare and Medi-Cal/Medicaid benefits. The American people don't want to see this happen. National, single-payer healthcare (H.R. 676) is pro-business, and pro-people.…

    • 340 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Worker’s Compensation frauds committed by employers consist of the biggest percentage of all. According to Johnson, employers is the real problem behind the frauds as it is the most expensive for insurance companies. While some states like Florida, California, Texas and Ohio is fighting all types of Worker’s Compensation fraud, others do not. In the estimate provided by the Department of Labor, between 10 to 30 percent of employers misclassified some employess15. Since the premiums are extremely expensive for the employers, they often underreport the payrolls and misclassify their employees in order to reduce the premiums that they have to pay to get coverage. Underreporting and misclassification not only cheat the insurance companies which…

    • 826 Words
    • 4 Pages
    Good Essays
  • Best Essays

    Medicare and Medicaid

    • 3491 Words
    • 14 Pages

    Fraud and Abuse of the Medicaid and Medicare programs in the United States is a widespread and pervasive problem. Institutions, health care providers and individual consumers all have a role in fraud and abuse prevention. It impacts everyone even if you do not currently benefit from one of these government programs.…

    • 3491 Words
    • 14 Pages
    Best Essays
  • Good Essays

    Medical Identity Theft

    • 638 Words
    • 3 Pages

    Medical identity theft is when someone uses your personal identity to use your medical insurance benefits to get free medical services and/or make false claims to gain financial assistance by using your identity. Medical identity theft accounts for 3 percent of identity theft crimes, or 249,000 of the estimated 8.3 million people who have had their identities stolen in 2005, according to the Federal Trade Commission. It is estimated that people who are affected by this crime are left with $40,000 + in bills for services they never used. Medical identity theft can take place in private doctor’s offices, hospital’s, or pharmacy’s. A single person or a group could be involved in this crime. Some people fear that with the electronic medical records from paper that it may be easier to get peoples medical identity. Many people don’t even realize that they have been a victim of this crime until months to years down the road.…

    • 638 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Mancilla and Moczygemba (2009) state, “ Medical identity theft is defined as “when someone uses an individual’s identifying information…without the individual’s knowledge or permission, to obtain medical services…by falsifying claims for medical services and falsifying medical records to support those claims” (para. 2). Healthcare providers must make consumers aware that there is identity theft going on for the purpose of stealing their medical information for fraudulent medical care and medical claims. There are some steps on how to avoid being a victim. MIB Group (2012) states, “While theft of your identity would likely impact your credit and run up some medical bills for uncovered services or co-pays in your name, it could also result in the addition of erroneous data into your medical file”(para. 2). Identity theft is not just stolen credit card numbers anymore. Thieves are stealing complete identities of other people. They are stealing medical record information such as insurance identification numbers. They are using this information for themselves to get medical work done and to make false medical claims and get paid for them. This causes financial issues for the victims and it could cause them to get false medical results which could affect their medical treatment. Patients need to guard their insurance identification numbers. Patients should contact their physicians if they…

    • 4094 Words
    • 17 Pages
    Powerful Essays
  • Satisfactory Essays

    Sicko Reaction Paper

    • 577 Words
    • 3 Pages

    In this interesting movie, Moore explains how the health care system works in the United States, and it is dysfunctional. According to the movie, there are two lucrative activities that are killing millions of people in this country because government is always supporting corporations and its owners. Since the government reformed the health care system, health insurance and the pharmaceutical industry are two lucrative activities where you not only need money but also “lucky”. In this system, you have to pay for a private health insurance, but at the same time, they are only interested in you money. If you have an accident or you just need medical assistance and you have some health insurance they are going to look for any detail that will deny medical assistance if it is expensive or not.…

    • 577 Words
    • 3 Pages
    Satisfactory Essays