Preview

Insurance Fraud and Pip

Better Essays
Open Document
Open Document
895 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Insurance Fraud and Pip
Date: 1/30/12
Name: Mayelin Acevedo
Paper #1 Assignment

Insurance Fraud and PIP
Automobile fraud has increased in the past years costing insurance companies millions of dollars in fraudulent claims. Further, this cost is being passed to consumers through increased insurance premiums. Insurance fraud is committed through staged accidents, fake medical treatment, and billing for services not rendered. PIP (Personal Injury Protection) is the primary target of auto insurance fraud in Florida. PIP was implemented by the legislators to provide immediate care and treatment for those involved in automobile accidents. The State of Florida requires that every motor vehicle driver carry PIP coverage, also known as no-fault coverage. This coverage requires insurance companies to pay up to $10,000.00 in medical bills and loss wages, regardless of fault. Legislators have been attempting to fix the system by filing bills in regards to the issues surrounding PIP, but none seem to achieve positive results. A new bill has just cleared aimed at preventing fraud in Florida’s Personal Injury insurance. The problem with insurance fraud is that the perpetrators seem to stay one step ahead of any legal actions or changes in the law and are able to find a loophole and get away with the crime; but the consumer should not have to pay for their illegal actions.
Not enough has being done to correct the ramping (is ramping the right word here? Rampant?) problems of fraud with PIP in Florida. It has been shown that PIP fraud will continue to increase premiums paid by consumers in Florida if not brought under control. There are several methods to combat this fraud: Legislative changes, increased punishment for the perpetrators of fraud and increased consumer awareness; all are necessary to resolve the problem. Thus far, only legislative changes have been proposed.
Among other things, this new bill stipulates that every crash victim is to be

You May Also Find These Documents Helpful

  • Better Essays

    Valerius J Bayes N L Newby C Seggern J I B 2008 Medical Insurance: An Integrated Claims Process ApproachValerius, J., Bayes, N. L., Newby, C., & Seggern, J. I. B. (2008). Medical Insurance: An Integrated Claims Process Approach (3rd Ed.). : McGraw/Hill Higher Education.…

    • 958 Words
    • 4 Pages
    Better Essays
  • Satisfactory Essays

    . Tags: HSA 515 - Strayer and Ethics, Code Blue – Emergent Care, Dealing with Fraud, Health Care Policy, Hsa 515, hsa 515 assignment 1, hsa 515 assignment 2, hsa…

    • 355 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    Creating a fake PPG won’t solve the issue here since we are still having claims processed with individual providers. I will wait until Suli sends me the claims report to have a deeper look into the claims. Given the urgency of this situation, I will get back to you as soon as possible with my findings and a suggested…

    • 117 Words
    • 1 Page
    Satisfactory Essays
  • Better Essays

    Hcs 545 Week 5

    • 1438 Words
    • 6 Pages

    Fraud, Abuse, and Waste in the US Healthcare System is a major problem. As a result of this the government is spending a greater percentage of the GDP on healthcare for Americans. The primary reason for this increase in the overall cost for healthcare is related to the increase in fraud, waste, and abuse. It is estimated that the United States spends between 15 and 25 billion dollars annually because of fraud, waste, and abuse. We will examine the [pic]types of fraud, waste, abuse, the[pic] involvement [pic]of the[pic] federal government in prevention, the roles of healthcare organizations and employees, and the protection for whistle-blowers and consequences for those involved in fraud, waste, and abuse.…

    • 1438 Words
    • 6 Pages
    Better Essays
  • Satisfactory Essays

    tort law

    • 320 Words
    • 2 Pages

    3) How were the elements of intentional infliction of emotional distress applied to that case? In other words, explain why the court concluded that there was enough evidence to establish intentional…

    • 320 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    * Health care is a vast ever-changing demand in the United States. Because of that high demand, quality has been a concern for many patients. Each day patients put their health and trust in the hands of health care providers. Unfortunately, there have been times when the treatment provided, whether accidental or intentional, has caused harm to the patient. Patients who have experienced injury have the right to file a civil complaint against that provider that caused the injury. Some possible reasons for civil complaints are that personal information for a patient was shared without proper consent, negligence, or assault. These injuries are covered under Tort Law. This essay will identify a civil complaint process that patients may follow in the event of misconduct or incompetence by a provider. The role of the regulatory agencies to investigate the allegations of the misconduct will be discussed along with how they apply disciplinary actions if warranted. Potential criminal liabilities, risk management strategies, quality assurance programs to reduce the risk of liability and the process to follow in the event that charges are filed against a provider will all be identified.…

    • 896 Words
    • 4 Pages
    Good Essays
  • Satisfactory Essays

    Health care fraud and abuse is a current issue affecting everyone in the United States costing billions of dollars annually. This fraudulent crime is committed when dishonest consumers and providers submit false or misleading information to turn profit. It affects the United States by hampering the ability to provide affordable access health care and good quality of care to Americans. The Affordable Care Act prevention resources and tools are working to stop fraud before it occurs. The purpose of this paper is to discuss a health news situation affecting the health care system and evaluate the effect of organizational structure and governance, culture, and social responsibility. Recommended resources to preventing this situation in the future and recommended changes in future prevention will be discussed.…

    • 441 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    DQ 1: With so many different stakeholders in the health care system, many with powerful political lobbies, it is understandable that the government has been unable to effectively address the problems of cost, access, and quality. With the passing of the Patient Protection and Affordable Care Act of 2010 (PPACA), the government has taken a step towards reshaping the health care system. Answer the following question:…

    • 682 Words
    • 3 Pages
    Satisfactory Essays
  • Best Essays

    Medicare Fraud

    • 2440 Words
    • 10 Pages

    References: Bennett, M. L. (n.d.). Criminal Prosecutions for Medicare and Medicaid Fraud. AAPS - Association of American Physicians and Surgeons. Retrieved October 11, 2010, from http://www.aapsonline.org/fraud/fraud.htm…

    • 2440 Words
    • 10 Pages
    Best Essays
  • Best Essays

    Medicare and Medicaid

    • 3491 Words
    • 14 Pages

    With the ever-changing difficulties of our health insurance landscape, the government has taken a more active role in the health care and well-being of American citizens. With this shift, programs like Medicare and Medicaid, become polarizing topics in an environment where individual finances are tight, our economy is struggling, and the future is no longer as predictable or financial secure as we once believed it to be. Medicare and Medicaid programs will be the focus of this analysis. The paper will explore the history behind these programs, some common fraud and abuse methods and techniques, and will finally discuss possible solutions and tactics in place to mitigate future manipulation of these programs.…

    • 3491 Words
    • 14 Pages
    Best Essays
  • Powerful Essays

    Healthcare Fraud and Abuse

    • 3859 Words
    • 16 Pages

    Werber-Serafini, Marilyn. "How Much Fraud." Healthcare.nationaljournal.com. National Journal, 29 Nov. 2009. Web. 1 Nov. 2011.…

    • 3859 Words
    • 16 Pages
    Powerful Essays
  • Better Essays

    Texas Medicaid Expansion

    • 1201 Words
    • 4 Pages

    References: Rich, R. F., Cheung, E., & Lurvey, R. (2013). The patient protection and affordable care…

    • 1201 Words
    • 4 Pages
    Better Essays
  • Powerful Essays

    Understanding Change

    • 1779 Words
    • 6 Pages

    In March of 2010, President Barack Obama signed into law The Patient Protection and Affordable Care Act (PPACA); legislation which has since become more commonly known as The Affordable Care Act (ACA) to industry professionals, and more colloquially as ‘Obamacare’ to the American people. However, many of the required changes necessary for healthcare organizations to remain compliant to the federal mandates have yet to take place. The implementation of industry changes on a magnitude as those facing American health providers is both incredibly difficult and complex.…

    • 1779 Words
    • 6 Pages
    Powerful Essays
  • Better Essays

    Health Insurance

    • 1684 Words
    • 7 Pages

    President Obama 's plan to insure healthcare for all marks a positive step for the well – being of our country 's citizens. Still, the Patient Protection and Affordable Care Act (PPACA) also known as ObamaCare has been one of the most controversial topics of our time. In order to understand why this is such a controversial topic we must understand exactly what this act means to the people. The Patient Protection and Affordable Care Act (PPACA) states that with limited exceptions, every resident of the United States must have health insurance that must meets certain basic requirements. Beginning in 2014, individuals who do not acquire health insurance will be subject to a fine. This fine will rise over time, reaching $895 per person or 2.5 percent of income, whichever is greater, by 2018. Beginning in 2014, each state is to establish an Affordable Insurance Exchange. Separate exchanges are to be established for individuals and small businesses with fewer than 50 employees. The intention is that private insurance companies will compete by offering policies on the exchanges to individuals and small businesses. Low – income individuals and small businesses with 25 employees or less will be eligible for tax credit to offset the cost of buying health insurance. For the employers, beginning in 2014, every firm with more than 200 employees must offer health insurance to its employees and must automatically enroll them in the plan. Firms with more than 50 employees must offer health insurance or pay of $3,000 to the federal government for every employee who receives a tax credit from the government for obtaining health insurance through their state 's health exchange. The government plans to regulate insurance companies by requiring all insurance to participate in a high – risk pool that will insure individuals with pre – existing medical conditions and were unable to get insured.…

    • 1684 Words
    • 7 Pages
    Better Essays
  • Good Essays

    Medicare Fraud

    • 335 Words
    • 2 Pages

    Medicare Fraud occurs when someone intentionally falsifies information or deceives Medicare (www.medicare.gov). Strike force accused ninety-four people across the U.S. The charges are based on several fraud schemes including Physical Therapy schemes, Healthcare schemes, HIV infusion schemes, and durable medical equipment schemes (Long-Term Living, Aug.2010, vol.59 issue 8, p10-10,8/9p). These schemes exceeded $225 million in false billings, which resulted in the largest health care fraud crackdown to date. Although Medicare Fraud has been around for years, it seems to be becoming more prevalent in recent times.…

    • 335 Words
    • 2 Pages
    Good Essays