Health Care Fraud and Abuse
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|Health Care Fraud and Abuse |
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|6/17/2012 |
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Health care fraud is the filing of dishonest health care claims to obtain a profit and is considered a white collar crime. Health care abuse is when someone overuses or misuse services. Both, Health care fraud and abuse, in the United States is an ongoing issue and is costing the United States government billions of dollars. Every time a fraudulent act is perpetrated the insurance company passes the cost to its customers. Due to the high volume of health care fraud statistics shows that 10 cents to every dollar spent on health care goes toward paying fraudulent health care claims. The federal government’s action to fight healthcare fraud and abuse brought forth The False Claims Act (FCA) of 1986. Under the FCA, the United States may sue violators for damages, plus $5,500-$11,000 per false claim. In a further effort to fight fraud and abuse, in 1993 the Attorney General announced that tracking healthcare fraud and abuse would be a top priority for the
|Health Care Fraud and Abuse |
| |
| | |
|6/17/2012 |
| |
Health care fraud is the filing of dishonest health care claims to obtain a profit and is considered a white collar crime. Health care abuse is when someone overuses or misuse services. Both, Health care fraud and abuse, in the United States is an ongoing issue and is costing the United States government billions of dollars. Every time a fraudulent act is perpetrated the insurance company passes the cost to its customers. Due to the high volume of health care fraud statistics shows that 10 cents to every dollar spent on health care goes toward paying fraudulent health care claims. The federal government’s action to fight healthcare fraud and abuse brought forth The False Claims Act (FCA) of 1986. Under the FCA, the United States may sue violators for damages, plus $5,500-$11,000 per false claim. In a further effort to fight fraud and abuse, in 1993 the Attorney General announced that tracking healthcare fraud and abuse would be a top priority for the
Cited: Advocacy, A. C. (2011). A Review of Health Care Fraud and Abuse in America. Agrawal S, B. P. (2012). Physician medical identity theft. PubMedCrossRef , 459-460. Investigation, F. B. (n.d.). 2011 Financial crimes report. Retrieved May 2012, from http://www.fbi.gov/stats-services/publications/financial-crimes-report-2011 Modern Healthcare. (2010, June 28). The new fraud offensive; It 's time to sto losing billions to fraud each year and redirect those dollars. . United States of America. Retrieved from www.lexisnexis.com/hottopics/Inacademic Quireshi. (2011). Enforcement Actions involving Medicaid fraud and abuse. Arch intern Med , 785. Report, N. H. (2008). National Healthcare Antifraud Association Report. U, R. (2012). protecting the growth of healh care income. PubMedCrossRef , 41-54. US Department of Health and Human Services. (n.d.). Office of Inspector General. Retrieved June 2012, from US Department of Health and Human Services: http://oig.hhs.gov/about-oig/about-us/index.asp These are just a few of the many precautions professional practices need to take to prevent healthcare fraud and abuse. And remember: Although many professional practices don’t even know they are a prime target for a healthcare data breach, a hacker halfway across the country could be putting them in his sights. Professional practices should not assume they aren’t at risk because they have a few employees and a relatively small number of customers. Not true. Hackers, like any criminals, focus on the most vulnerable.