Medicare: A Case Study

Medicare is an insurance program that is controlled entirely by the federal government that is managed by the Centers for Medicare and Medicaid Services (CMS) provides health coverage for Millions of Americans that are 65 and older and that physical challenge. In regards to the legal issues that involve Medicare. One particular issue involves health care providers being deceitful and committing crimes of fraud and abuse to third party payers, other physicians, and health care vendors. Providers billed for services that were not performed or needed. Some even billed for a higher level of service than provided. The identities of providers and patients were stolen. Also, issues concerning providers not providing the appropriate quality medical
care for patients.

Blue Cross Blue Shield (BCBS) is a private insurance program that is located in every state. BCBS offers a variety of insurance such as health plans. Also, they offer dental, vision, and some plans for Medicare to fill in the gap for cost such as Medigap. The legal issue that involves private payers is constantly concern about ensuring the consumers that their private information is safe. Although companies go to the extent of making sure that they have safety measures in place by installing a firewall and other security programs. They also, change their passwords frequently as issues of privacy, security, and confidentiality are a challenge because of identity theft. The private payer is required to safeguard the identity and personal information of their consumers.