Medicaid and Medicare Fraud Describe health news story combating health care fraud Medicare Medicaid• Examine evaluate corporate structure governance, culture, focus social responsibility • Recommends Medicare and Medicaid fraud: An ove Continue Reading...
Fraudulent activities such as these resulted in violations under the act, including a fine of not more than $25,000.00 or imprisonment for not more than five years, or both. Analysis of Current Fraud legal analysis of the current fraud committed in Continue Reading...
President George Bush proposed a two part strategy with initial implemented drug coverage to low-income beneficiaries coupled with a White House task force to develop a plan to reform Medicare (Health Policy, 2001). Under this plan beneficiaries wit Continue Reading...
Healthcare Law -- Ethics & Policy Memo to ABC Hospital Board of Directors: How to develop strategies to help mitigate abuse and fraud within our organization by understanding fraud and abuse issues. The Department of Health and Human Services h Continue Reading...
Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration (HCFA), that by the time 2011, health care expenditure will arrive at $2.8 trillion, as well as it will bill for 17% of the Gross Domestic Product. As a result Continue Reading...
Fraud and Abuse Case Healthcare fraud and abuse continues to threaten the country, costing the facility billions of dollars per year. Brodeur, (2007) stated that fraud is something difficult to understand because it is a contagious issue. Healthcare Continue Reading...
Medicaid Health Care Assistance How does the organization fund its programs? Medicaid was developed for the sole purpose of providing health care services to low income individuals and families. For those people that cannot afford to pay for these Continue Reading...
Furthermore, we cannot forge a safe harbor under 42 C.F.R. §1001.952(p), because Sundown Community Hospital is not a physician's group (Altshuler, Creekpaum, & Fang, 2008). Finally, the proposed arrangement does not fall within the safe har Continue Reading...
CASE STUDY 6.3: SINGLE-PAYER SYSTEM 1AbstractCase 6.3 seeks to assess the cost-effectiveness of the Medicare for All system. It discusses the cost savings to be realized by insurers, providers, and patients in implementing the Medicare for All system Continue Reading...
Miscoding on the Billing Forms Discussion Board The fundamental basis for auditing Medicare and Medicaid billing is that the services provided are confidential, patient privacy must be protected, and the written word of the provider is the record of Continue Reading...
Amerigroup Illinois Inc. Fraud CaseAmerigroup Illinois Inc. was found guilty in 2006 under the Federal Claims Act and the Illinois Protection Act. Amerigroup and its subsidiaries denied enrolling pregnant women and unhealthy patients in its managed c Continue Reading...
Essay Topic Examples 1. The Necessity of Medicare Reform for an Aging Population: This essay would explore the demographic changes and the increasing number of elderly in the United States, examining the strain on Medicare resources. It would loo Continue Reading...
The facts that you have provided indicate extremely troubling circumstances that could seriously jeopardize the welfare of your organization. It is well-settled law that entities contracting for the services of subsidiaries are legally responsible Continue Reading...
Insurance Fraud After tax evasion, insurance fraud is considered the highest-ranked among white-collar crimes. The original concept of insurance, as a for-profit endeavor, was to collect funds from a large number of people to pay for damages and acc Continue Reading...
The safe harbors do not cover every area of permissible behavior, and an arrangement may not qualify as a safe harbor, but still not subject someone to the risk of prosecution. In fact, the courts have interpreted the Federal Anti-Kickback Law rela Continue Reading...
Corporate fraud as a dishonest activity for organizations that is considered as white collar crime has serious legal implications. Though it can be difficult to detect and catch, it is important to prevent it by creating effective and efficient polic Continue Reading...
The Act creates a positive balance between government interests to save money and the interests of Medicare recipients to receive a wide range of drugs for their specific needs. The current ban on government negotiations with pharmaceutical companie Continue Reading...
Reimbursement Ethics and Compliance: Impact of Health Care Reform on Medical Coding and Billing "Medical billing and coding lays the foundation for any successful healthcare provider," yet its common practices are undergoing significant changes unde Continue Reading...
Safety net hospitals have traditionally provided medical services vital to public health. Unfortunately, the recent economic recession has dealt a hard blow to safety net hospitals, even to the point of forcing hospital closures. Fortunately, Health Continue Reading...
Healthcare Integrity is a major issue for healthcare organizations because there are many avenues for fraud, and for people to demonstrate a lack of ethics. The problem is that the temptation is sometimes too great and despite the fact that there ar Continue Reading...
Future of Managed Care Medical facilities have become much more important today than they were ever before. The complex diseases are treated by treatment methodologies and the equipment that were nonexistent a few decades ago. But these facilities h Continue Reading...
Registered nurses are both qualified, educated, and certified to provide a high quality of various care services that an individual may need in a home setting or elsewhere. Hence, providing these practitioners with the power to certify and provide h Continue Reading...
Liability Criminal Liability and Healthcare Organizations Providing the highest quality care possible to patients is of course the overarching goal for any ethically operating medical establishments, and should guide most practices. There are othe Continue Reading...
However, this might turn competent healthcare professionals away, who were angry that they no longer could exercise discretion over their treatment, in conference with their patients. Patients might refuse to come to the hospital. And those that did Continue Reading...
Beneficiaries of Three U.S. Social Programs In the last two years, there has been a major reform of Medicare, Medicaid and other federal health care programs like the State Children's Health Insurance Program (SCHIP) under the general rubric of Obam Continue Reading...
Affordable Care Act What is the ACA? The 2010 Affordable Care Act or the PPACA (Patient Protection and Affordable Care Act - HR3590), nicknamed Obamacare, is the latest American healthcare reform legislation. The PPACA encompasses the Patient Prot Continue Reading...
Healthcare Spending The United States Health Care System is probably the worst organized system. It expends double than other developed countries on health care system but face worse outcomes. The Government is running healthcare programs but still Continue Reading...
Elderly Care in America: A comparison with England's Healthcare System Healthcare in America vs. Healthcare in England Different countries have varying healthcare systems across the world and the systems are set to benefit the local population with Continue Reading...
The success of PPACA, and its provisions for people who are currently or chronically uninsured, will depend on reform of public programs as well as private insurance practices to create "new pathways to coverage (Gulley) and address the problematic Continue Reading...
Essay Topic Examples 1. The Impact of Medical Reimbursement Policies on Patient Care: This essay could explore how reimbursement policies affect the quality and accessibility of healthcare services. Does the reimbursement mo Continue Reading...
Personal Healthcare Technology Sunrise Hospital and Medical Center and the Sunrise Children's Hospital The Sunrise Hospital and Medical Center, which includes the Sunrise Children's Hospital, is an approximately 55-year-old facility located in Sout Continue Reading...
HEALTH ISSUES Health Issues to ResolveThe issue with legislative policymaking is that it has to be transparent and efficient in its decision-making to provide justice to the eligible ones without making matters delayed or worse. The accountability le Continue Reading...
President Clinton's And Obama's Health Care Policies: Since the 1960's, universal health care has continued to be a major aspect of social reform to an extent that the right to health care for all Americans has been a central issue in political deba Continue Reading...
Professional Capstone: CredentialingIntroductionOne of the most crucial processes in the realm of healthcare happens to be the process of credentialing. To a large extent, this has got to do with the assessment of the capabilities and competencies of Continue Reading...
(Chizek, 2003) The Role legal nurse consultant may provide service in a number of roles, including but not limited to: Consulting expert Testifying expert Facility-based investigator Trainer and in-service presenter Peer reviewer Quality impr Continue Reading...
healthcare services, many people could encounter some form of discrimination on the basis of their race, gender, or even sexual orientation. Discrimination in healthcare may seem like it is not something that is a major issue. However, it absolutely Continue Reading...
Healthcare and Revenue Cycles When it comes to the revenue cycle and receivables management, a healthcare organization faces unique challenges. These challenges include the fact that many clients (patients) cannot afford the care they are there to r Continue Reading...
health law and administrative law, according to Jost (2004), are law domains that are representative of the various approaches to classification. By definition, "health law encompasses law as it affects a particular industry -- the health-care indus Continue Reading...
They are also required to assess and address risks to customer information in all areas of operations, including employee management and training, information systems, and detecting and managing system failures. They must address what information is Continue Reading...
