Ethical and Legal Perspectives in Essay

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Total Length: 1296 words ( 4 double-spaced pages)

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Page 1 of 4

Through its partnership with the Department of Justice and the Human Health Services, the HEAT has expanded data sharing and improved information sharing procedures in order to get critical data and information into the hands of law enforcement agencies to enable them track patterns of fraud and abuse, and increase efficiency in investigating and prosecuting complex health care frauds (Department of Health and Human Services, HHS, 2011). The DOJ and the HHS have established cross government health care fraud data intelligence sharing work group that helps to improve awareness across the government on issues related to health fraud.

Student 2

The Healthcare Fraud and Abuse Control Program (HFAC) is enshrined in the section 1128c of the social security Act. This Act authorized the Health and Human Services and works through the office of the inspector general and the department of justice to ensure that the control and designs towards control of federal fraud and abuse are in place. This program is primarily meant for coordination of the federal, state and the local law enforcement programs with the aim of curbing fraud and abuse within the healthcare sector. They are also to conduct frequent audits, investigations in cases of lack of clarity, evaluations as well as thorough inspections with the ultimate aim of ensuring prompt and quality delivery of healthcare services to the citizens.

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This program is also meant for the enforcement of the healthcare abuse as well as fraud laws that are in place. They are also entrusted with issuing alerts ahead of time as well as advisory services and opinions in various circumstances. Once they have conducted conclusive investigations, this department is them charged with the responsibility of giving the final adverse actions that should be taken against a health care provider, professional or even supplier who is found culpable (American Medical Association, 2013).

Part C

The review of laws that address fraud and abuse especially the False Claims Act has made me appreciate the laws cuts across the board and also applies in the health care sector. I have also learnt to appreciate that a private litigant under the qui tam provision can bring an action against a perpetrator on behalf of the United States government. The relators otherwise known as whistleblowers in other quarters can receive 15 and 30% of any judgment or settlement in the government's favor. Regarding the fraud enforcement programs I have appreciated the critical role Health Care Fraud and Abuse Control (HFAC) Program plays in cracking down perpetrators who abuse the system that costs an average American tax payer billions of dollars......

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