StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Ombating Healthcare Fraud and Abuse - Essay Example

Cite this document
Summary
The article, ‘Penalizing substandard care: The next step in combating healthcare fraud and abuse’ by Hoffman, Geroux and Schwartz is highly illuminating in its content. Health care delivery system is one of most important elements of public welfare schemes of the government…
Download full paper File format: .doc, available for editing
GRAB THE BEST PAPER97.7% of users find it useful
Ombating Healthcare Fraud and Abuse
Read Text Preview

Extract of sample "Ombating Healthcare Fraud and Abuse"

 Сombating Healthcare Fraud and Abuse The article, ‘Penalizing substandard care: The next step in combating healthcare fraud and abuse’ by Hoffman, Geroux and Schwartz is highly illuminating in its content. Health care delivery system is one of most important elements of public welfare schemes of the government. The various components of healthcare plan become hugely essential for the effective delivery of the same. But in the recent times, the accessibility to quality medical care, effective Medicare, patients’ rights, Medicare fraud etc.

have emerged as major issues. There is urgent need to address the issue of deteriorating quality in care and increasing fraud in the Medicare. The sub standard care, especially that of aging population and under privileged segment of society has become a key concern for the government. In recent times, different departments: DOJ or Department of Justice, HHS or Health and Human Service office of Inspector General (OIG), HCCA or Health Care Compliance Association, CMS or Centers for Medicare and Medicaid Services etc.

have collaborated with federal and state governments to fight against fraud and sub quality of healthcare. I believe that government initiative in addressing the issue from three main fronts is hugely commendable: punishment for delivery low level of care and reward for high performance; fraud and abuse; training and compliance. There is urgent need to punish the providers who are duping the patients and the government through sub quality services vis-à-vis inadequate staffing, incomplete care, improper medication management, neglect etc.

The Pay for Performance initiatives by various hospitals encourages improved service delivery. Health providers found to be deficient in their services are penalized. More than 375 quality measures covering almost all aspects of healthcare delivery have been developed to promote quality healthcare. Public disclosure and accountability has been intrinsic part of quality mechanism that monitors patient care outcome. Fraud and abuse in CMS services have also emerged as critical aspects of sub standard care.

There is high degree of chances of committing fraud by the various service providers like doctors, chemists, laboratory tests, medical goods supplier, hospitals etc. as Medicare and Medicaid is disbursed through healthcare providers to needy patients. Under FCA or False Claim Act, the government had recovered nearly a billion dollars in the first ten months of 2009!Involvement of various agencies like HCCA, AHLA or American Health Lawyers Association etc. for educating healthcare professionals and Boards with healthcare compliance guidelines are important government initiatives for improving quality.

The checks and measures for implementing the requisite guidelines are critical mechanisms that have helped to improve quality. Indeed, financial penalties along with Civil and Criminal actions against the agencies have significantly impacted the outcome and helped improve quality. Stringent penalties for substandard care and fraud in Medicare and Medicaid are key initiatives of government that have huge ramifications for future. The recoveries from the service providers for inappropriate level of care, fraud and false claims will serve as major deterrents for the various service providers and agencies involved in the delivery of healthcare services.

The collaborated efforts of various agencies and government would indeed help to curb Medicare and Medicaid fraud. At the same time, it is expected that the compliance guidelines would contribute to higher levels of care in healthcare delivery.(words: 533)ReferenceHoffman, Max R., Geroux, Debra A., and Schwartz, Robert H. (April 2010). Penalizing substandard care: The next step in combating healthcare fraud and abuse. The Health Lawyer, 22(4), 1-12.

Read More
Cite this document
  • APA
  • MLA
  • CHICAGO
(“Ombating Healthcare Fraud and Abuse Essay Example | Topics and Well Written Essays - 500 words”, n.d.)
Retrieved de https://studentshare.org/health-sciences-medicine/1590689-penalizing-substandard-care-the-next-step-in-combating-healthcare-fraud-and-abuse
(Ombating Healthcare Fraud and Abuse Essay Example | Topics and Well Written Essays - 500 Words)
https://studentshare.org/health-sciences-medicine/1590689-penalizing-substandard-care-the-next-step-in-combating-healthcare-fraud-and-abuse.
“Ombating Healthcare Fraud and Abuse Essay Example | Topics and Well Written Essays - 500 Words”, n.d. https://studentshare.org/health-sciences-medicine/1590689-penalizing-substandard-care-the-next-step-in-combating-healthcare-fraud-and-abuse.
  • Cited: 0 times

CHECK THESE SAMPLES OF Ombating Healthcare Fraud and Abuse

Preventing Fraud, Waste, and abuse Simulation

ith the increased federal and state government expenditure on health care each year, the concerns of fraud and abuse also increase.... A lot of money has been lost to fraud and abuse allegations with CMS estimating about 15 to 25 US dollars per year in Medicaid fraud and close to 1.... It is, therefore, necessary that everybody in the company is conversant with the knowledge of fraud which include how to identify fraud and abuse, prevention, and reporting of abuse and fraud....
6 Pages (1500 words) Essay

The Great Trafficking Debate

2004) Because they lack the proper documents, trafficked women live in fear of authorities who have also been known to abuse their position by forcing themselves on the women.... UN peacekeeping operations were rocked by a sex abuse scandal in the Congo that caused the organization to reexamine current training policy.... (Trafficking in Persons Report, 2006) Apparently, refugees, including many minors, were victims of sex abuse crimes by dozens of peacekeepers on a mission in Congo....
10 Pages (2500 words) Essay

Pressure ulcers disease

The Never Event Policy was generally instituted to ensure that hospitals and healthcare facilities give the very best of care to patients so that patients would not have to come out of hospitals and health facilities with new illnesses.... The following study "Pressure ulcers disease" concerns the origin of the mentioned disease....
4 Pages (1000 words) Case Study

Closing the Gap in health disparities

‘Penalizing substandard care: The next step in combating healthcare fraud and abuse.... … Obama's healthcare initiatives have addressed crucial areas that impact effective delivery and the ones that are vulnerable to fraud and malpractice.... Obama's healthcare initiatives have addressed crucial areas that impact effective delivery and the ones that are vulnerable to fraud and malpractice.... While CBO report has undermined the importance of malpractice premiums in insurance and ignores the wider ramifications of defensive medicine in the increased cost of healthcare, medical malpractice reforms must continue as they have become hugely critical aspect of effective and universal healthcare....
1 Pages (250 words) Dissertation

Children with Attention Deficit Hyperactivity Disorder

Since Ritalin is the readily available drug for ADHD, its abuse is very common too.... Attention deficit hyperactivity disorder (ADHD) is a very common childhood mental illness which can continue till early teenage years and in very rare cases to adulthood.... Its symptoms include difficulty in staying focused and concentrating, hyperactivity and being very… These symptoms affect the kids in competing and succeeding in the early school years, and doing simple everyday life activities with difficulty....
7 Pages (1750 words) Term Paper

Human Trafficking

According to the UNDOC, human trafficking is the acquisition of people by illegal means such as force, fraud, deception, abduction or coercion for the purpose of exploiting them.... This vice is one of the main international policy concerns of the 21st century that is spreading at… Often, human trafficking is confused with human migration and smuggling even though the three terms are completely different....
11 Pages (2750 words) Research Paper

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

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.... The Medicare and Medicaid programs were developed in 1965 in which legislation provided framework for Medicare and Medicaid services in the country through strong administrative and regulatory authority; … CMS has been authorized to protect Medicare Trust Funds by detecting and preventing fraud, abuse and waste....
14 Pages (3500 words) Research Paper

The Treatment of Refugees and Immigrants

The paper 'The Treatment of Refugees and Immigrants' presents Immigrants who are growing in numbers and also in political power and have vital things to add to the cultural mix of the US.... Therefore it is significant that the average person in the US has an accurate.... hellip; There will always be a negative reaction to xenophobia in the US, however, which tries to bend the facts and use propaganda in an insidious manner....
5 Pages (1250 words) Case Study
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.
Contact Us