is to report on health care practices and ethics in finance. This paper will address topics such as Generally Accepted Accounting Principles (GAAP)‚ corporate compliance‚ ethics‚ or fraud‚ and abuse. This paper will include two articles regarding Medicare fraud in Texas and what the state is currently doing to safeguard the affected population regarding this issue. Finally‚ this paper will give a detailed summary of the four elements of financial management. Health care has become a global
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is not inexpensive. According to the Centers for Medicare & Medicaid Service‚ U.S. health care spending reached $2.7 trillion in 2011‚ or $8‚680 per person. This is 17.9 percent of the Gross Domestic Product. Health spending grew by 3.9 percent which was the same growth rate as in 2009 and 2010 (Center for Medicare and Medicaid Services [CMS]‚ 2011). Because health care is so expensive it makes it difficult for those without health
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clinically‚ clinical and consumer insights and member experiences. In the year 2016‚ over 70 percent of their total services revenue and total premiums were from the federal government‚ fourteen percent of which was derived from their individual Medicare Advantage contracts with are in Florida with CMS. Under CMS they provided health insurance coverage to almost 600‚000 members as of December of 2016. (Annual Report‚ 2016) The birth of Humana was in 1961‚ where it was founded
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such as the parents of the spouses; or (b) horizontal extensions - including members of the same generation as the spouses - such as the wife’s brother. There have been challenges to the thesis that the family is universal. For example‚ Kathleen Gough studied the Nayar of Kerala in Southern India prior to the establishment of the British Raj in 1792. In this society marriage took the form of a ritual connecting a girl to another Nayar man‚ but partners of such a marriage did not cohabit‚ and the
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revenue flow for providers. Medicare and Medicaid payers are well known for reimbursing on a fee-schedule basis. However‚ recent research has shown that 56 percent of the American population has some line of commercial healthcare insurance and those plans tend to pay on average‚ 61 percent higher reimbursement on some Diagnosis Related Groups-DRGs than Medicare(Perez‚ 2017). Even though Medicare may reimburse on a lower scale in many cases‚ many commercial plans follow Medicare guidelines as to which
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resources may be sorely compromised‚ sometimes destroyed. What can be done to help this population through the transition into retirement? There are programs that do assist them including Social Security‚ Medicare and Pensions‚ however is it enough? The Social Security Act of 1935 along with Medicare have helped many Americans since they have been around and have many great advantages‚ but it seems to be getting harder and harder for our elderly population to get the assistance that they need. In today’s
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Portable home oxygen unit-GY – identifies rental or purchase of durable medical equipment for use in the patient’s home; is statutorily excluded‚ does not meet the definition of any Medicare benefit or for non-Medicare insurers‚ is not a contract benefit‚ is appended to procedures that are excluded from the Medicare payment system. b) Left trigger thumb release–FA- left hand‚ thumb- Modifiers used in conjunction with the procedures of the hand‚ feet‚ and eyelids. The modifiers will not affect
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are >65 years old‚ straight Medicare A‚ and are final coded with one of the seven diagnoses. Hospitals are focusing on ways to prevent readmissions by identifying patients while in hospital‚ post-acute‚ and evaluating readmissions and the effects on the hospital. This is a form of measure for hospital quality improvement‚ payment purposes‚ and public reporting. A goal of President Obama’s and Congress was the amount being spent of readmissions reported by Medicare Payment Advisory Commission
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New Policy for the APRNs Natalie Fleagle Widener University New Policy for the APRNs America Nursing Association (ANA) supports the ability of Advanced Practice Registered Nurses (APRNs) to certify Medicare patients for home health services. ANA believes that APRN should be able to certify patients for home health care and to develop and sign their plans of care in accordance with state law (ANA‚ 2012). The Affordable Health Care Act (ACA) presents many opportunities for a APRNs and
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senior population. In 2012 Medicare spent 377 billion dollars on inpatient hospital stays. Due to the increase in inpatient hospital stays‚ by the Baby Boomer generation‚ the modern-economy has experienced positive and negative outcomes (Moore‚ B‚ PhD‚ Levit‚ K‚ B.A.‚ Elixhauser‚ A‚ PhD‚ 2015). Medicare and Social Security Administration going bankrupt—this is due to the finite federal budget
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