MEDICARE FRAUD Bobby Brown Colorado Technical University 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
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Medicare and Medicaid There are various types of insurances in today’s world. Two of them being Medicare and Medicaid. Founded in 1965 as part of President Lyndon Johnson’s "Great Society"‚ they share differences and few similarities. They are social insurance programs that allow the financial burdens of illness to be shared among health and sick individuals‚ and affluent and low income families. Medicare is a federal program that provides health coverage if yon are 65 years or older‚ are a younger
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Healthcare Systems are Complex Adaptive Systems (CAS) because they are heavily influenced by both internal and external environmental factors. Healthcare institutions have a large number of stakeholders‚ which encompass individual health consumers to larger groups such as public‚ private‚ and federal payers. Institutions are further influenced by local‚ state‚ and federal regulations. With so many relationships at play‚ the healthcare system remains an unpredictable high-risk environment. Over the
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the Medicare rule for observation is very complex and confusing. The intention of the rule is to set clinical criteria for observation‚ and rapidly discharge the patient in twenty-four hours. However‚ this does not always happen. Some observation patients can stay up to ninety-six hours before being discharged or switched to observation status. One of the problems is individual health care organization interprets the Medicare rule differently. Then if the patient had a managed care Medicare carrier
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Some of the key drivers affecting the U.S. healthcare delivery system are cost of care‚ increase in need for healthcare workers and the demographics and needs of the patients. An article written by Ed O’Neil states‚ “the first and most overwhelming factor will be the current cost of care. At greater than 16% of the nation’s total productive effort‚ the US approach to organizing and delivering health care services is the most expensive in the world in the aggregate and per person” (2008‚ p.1). Health
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Medicare Advantage The article I found is about Medicare Advantage and its main points are basically about how Obama and some democrats think that it is waste of money to have. But not everyone agrees with them. A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations‚ Preferred Provider
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obtain Medicare is very comforting. Medicare is a federal health care program that was put in place by Congress in 1965 to provide health insurance to Americans sixty-five and above. Medicare was then expanded in 1972 to also cover younger individuals who are disabled (Kaiser‚ 2012). Traditional Medicare provides coverage to all Americans sixty-five and older without taking into account income. Prior to Medicare a whopping fifty percent of seniors lacked health coverage (Center for Medicare Advocacy
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Telecommunications Advances and the Impact on Healthcare In today’s healthcare‚ people want more access to their doctors and their records. A lot of people don’t have time to actually sit in a hospital. So that leaves the question‚ how can a person stay in contact with their doctor and their information? Some say that the solution is Telemedicine. According to (Darkins & Cary‚ 2000) Telemedicine is the use of electronic communication and information technologies to deliver healthcare when distance separates
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The Canadian healthcare system is based on the publicly funded “Medicare” programme since the 60s. Canada’s healthcare system represents a national health insurance model which uses private sector providers while payments come from a government insurance programme that every citizen is obliged to pay. In 2013‚ the 35.2 million people living in Canada have spent in health $4.351 per capita in total (public‚ private and out of pocket) which represents 10‚2% of GDP‚ nearly to the average health spending
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Henrietta Thies HLT-205 7-23-2010 Dr. Michael J. Rothrock The Netherland’s new health care system for all has received recognition as a possible pattern for the U. S. to restructure its health care system. Let us compare the two and see how they relate to one another. The study of 2009 (Health Care in the Netherlands and the US: A Comparative Study) looked at the Dutch and U. S. health care expense for a family of four. Frank Thomas and John Lawrence‚ who are editors/writers for the San
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