Health Care Fraud Term Paper

Health Care Fraud Term Paper-7
Insurance fraud is one of the most common types of frauds seen nowadays.Most people have heard of this type of fraud and may even have stories of it....

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There are warning signs for every type of fraud out there.

To understand the warning signs of fraud, we must first know what fraud is.

These costly reforms sought to improve financial disclosures from organizations, establish audit standards, inspect accounting firms, and enforce compliance with all rules highlighted by the Sarbanes-Oxley Act.

However, fraud occurrence has not been impacted....

Health care fraud is a type of white-collar crime that involves the filing of dishonest health care claims in order to turn a profit. Practitioner schemes include: individuals obtaining subsidized or fully-covered prescription pills that are actually unneeded and then selling them on the black market for a profit; billing by practitioners for care that they never rendered; filing duplicate claims for the same service rendered; altering the dates, description of services, or identities of members or providers; billing for a non-covered service as a covered service; modifying medical records; intentional incorrect reporting of diagnoses or procedures to maximize payment; use of unlicensed staff; accepting or giving kickbacks for member referrals; waiving member co-pays; and prescribing additional or unnecessary treatment.

Members can commit health care fraud by providing false information when applying for programs or services, forging or selling prescription drugs, using transportation benefits for non-medical related purposes, and loaning or using another’s insurance card.Fraud is the intent to trick someone or lie to someone in order to receive financial gain.This definition varies depending of the type of fraud used, but the person committing the fraud is always looking for financial gain. You have Medicare fraud, internet fraud, mortgage fraud, loan fraud, tax fraud, embezzlement, forgery, insurance fraud, and marriage fraud....When a health care fraud is perpetrated, the health care provider passes the costs along to its customers.Because of the pervasiveness of health care fraud, statistics now show that 10 cents of every dollar spent on health care goes toward paying for fraudulent health care claims. Postal Service, and the Office of the Inspector General all are charged with the responsibility of investigating healthcare fraud.The adverse impact on Health South stakeholders will be discussed along with an analysis of the judicial outcome and fairness of punishments, with a conclusion on how ethics played a role in the government’s responsibilities and actions....[tags: Richard Scrushy Fraud] - Thesis Statement The use of steroids by athletes has become very prevalent to improve performance in their sport, and have a better physical appearance, in order to get fame and money.He then subsequently files an expense report for these meals.The meals were not overly extravagant expenditures and thus are “lost” in the overall expense report....[tags: Insurance, Life insurance, Insurance fraud, Fraud] - Introduction This report will attempt to clarify the culture at Health South with Richard Scrushy as the CEO; how his management style contributed to the company’s ethical and financial damages and his own downfall.There will also be an analytical comparison of other companies and CEO’s who had similar company cultures.

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