Insurance Fraud A gang of Russian crooks ran a record-setting‚ $279 million fraud that exploited New York’s “no-fault” auto –accident law‚ authorities said 2/29/12. The gang worked with corrupt doctors to set up more than 100 phony medical clinics across the city. There‚ they generated fake bills for the treatment of “injuries” that “ranged from wild exaggerations to outright fabrications‚” Manhattan US Attorney Preet Bharara said. The fraudsters took advantage of the “patient-friendly provisions”
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Accountability is a situation in which people who exercise authority are controlled by external means and internal norms Medical ethics the amount to which a person is accountable to a superior authority. (1) A condition in which individuals who exercise power are constrained by external means and internal norms. (2) Taking responsibility for one’s own actions and defending them to anyone who asks (McGraw-Hill‚ 2002). Why is accountability important in the health care industry? Accountability
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Despite incredible improvements in health since 1950‚ there are still a number of challenges‚ which should have been easy to solve. These are some facts: One billion people lack access to health care systems. • Cardiovascular diseases (CVDs) are the number one group of conditions causing death globally. An estimated 17.5 million people died from CVDs in 2005‚ representing 30% of all global deaths. Over 80% of CVD deaths occur in low- and middle-income countries. • Over 8 million children under
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The Importance of Accountability Paper Jason Green HCS/475 12-18-12 Angie Barr The success of any organization deeply relies on the accountability of each individual employee within the organization. Accountability is the act of accepting and carrying out one’s responsibilities (Porter-O’Grady & Malloch‚ 2007). Accountability‚ in the business sense‚ refers to an individual that can be counted on to fulfill responsibilities‚ and when mistakes or lapses occur this individual is willing
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Impact of the Health Insurance Portability and Accountability Act On Health Information Professionals Renna Damon Texas A&M University Kingsville In the early 1990’s the major topics of discussion in regards to healthcare reform were how to provide greater access to healthcare and address major administrative concerns throughout the industry (AMA 2011). Congress created and passed the Health Insurance Portability and Accountability Act (HIPAA)‚ in 1996 in order to combat multiple issues at
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the basis for revenue and reimbursement for healthcare facilities. When a health record is coded based on quality documentation‚ then that should allow for the maximum reimbursement by the third party payer to the facility. If the medical codes are entered correctly‚ the procedure or treatment is medically necessary‚ and preauthorized according to the insurance company then the claim should be approved. For example if a health record is coded for gram negative pneumonia and the documentation supports
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Health Care and its Rising Costs Dusti Lott Ashford University HCA305 – The U.S. Health Care System Professor Thomas November 11‚ 2012 Introduction The dramatic rise in health care costs over the last century and into the current one has many contributing factors. Although each of these factors is not exclusive‚ they all have their own distinct personality. Each factor does cross over in to all others to have an affect on each other. We can follow the time line to understand the
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Many employers are now requiring mandatory drug testing for applicants and current employees. Drug use has risen sharply over the past years and employers now need to take further precautions in order to maintain a reputable work environment. I believe this extra precaution will improve the workplace by creating a safer atmosphere‚ keep integrity and honesty in the staff‚ and eliminate many illegalities that go along with drug use in the workplace. These qualities would be further infused if drug
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interest of Health Information Technologies has grown throughout the years with the implementation of the Health Information Exchange (HIE) and Electronic Health Records (EHRs). The federal government even set aside $27 billion for a program that encourages U.S. physician offices and hospitals to invest in a fully functional electronic records system. The adoption of EHRs throughout the healthcare industry has been advantageous as it improves both service quality and clinical quality of care. Patient
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must now consider the limitation of this same five forces model. • Care must be taken not to under estimate or underemphasize the importance of the existing strengths of the organization‚ • It does not cope with synergies and interdependencies within the portfolio of large corporations‚ • From a more theoretical perspective the model does not addressed the possibility that an industry could be attractive because certain companies are in it‚ • Some claim
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