Fraud and Abuse in the Healthcare System Essay -- Healthcare, argumen

healthcargon services have been on the rise for over 10 years now. According to a 2012 consumer alert, the industry provided $2.26 trillion in payments for more than four-spot billion health insurance benefit postulates in the year 2011(Fraud in wellness Cargon). The bulk of the claims and the mainstream of fraud and abuse stem from the Medic are system professionals, who are knowledgeable about the process and persuade new clients into handing over their clever information in hopes of deception and illegitimate claims. Multiple and double billing, dishonorable prescriptions, are some of the major flaws in this organization that has made the healthcare services industry curdle. (AGHAEGBUNA, 2011) This is a non-violet crime and is often committed by very educated people including business people, hospital, doctors, and administrators.Multiple billing on that point are numerous amounts of billing codes within the Medicare system. Many have the selfsame(prenominal) codes to one medical piece of equipment. If a biller tries to make a claim for a device, such as a wheelchair and walker, and the claim was denied based on excessive usage of that particular code because of its geographic region, then the biller tooshieful easily resubmit the claim using an alternative code that forget allow the claim to go through with minor alternations to the device (AGHAEGBNO, 2001). The biller can complete this task several times until the claim is satisfied. The biller can as well as bill for services that were not provided in order to receive higher(prenominal) payments from health care providers. These are forms of multiple, double and improper billing abuses that are defrauding the system tremendously. Health care claims are coming in quick and some payments are even expedited and reused to medical provide... ...gram polices and laws that have been put in place by OIG are making an impact with tracking duplicitous providers and claims. Claims need to be reviewed to ensure each claims are before they are paid, to ensure money is not being wasted. Fraud and Abuse testament remain a problem unless the government cracks down on providers. kit and caboodle CitedAghaegbuna,O (2011). Health care fraud and punishment. FDCH Congressional Testimony. Middle Search add-onFraud in Health Care The scope of the problem. (2012). Health Source-Consumer variation Gatty.B (2010). Fighting Fraud US Government cracking down on those who commit healthcare scams Dermatology Times, 31 (11)12.Health Source-Consumer Edition Haddad,M (2010).Technology helps track healthcare providers. Health Management Technology, 31 (5), 24-25. Health Source-Consumer Edition