Anthem Breach And Behavioral Analysis

Organizational misconduct is the chief cause behind corporate accounting scandals. The trusted executives of the corporation participation in actions during a scandal are corrupt and illegal. In the United States, the Securities and Exchange Commission (SEC) is typically the government agency that investigates such scandals. One of the most notorious corporate accounting scandals in the United States is the HealthSouth Corporation scandal of 2003. HealthSouth Corporation is one of the United States largest health care providers with locations nationwide. A deeper inspection of the HealthSouth scandal is needed to understand how it transpired by assessing how it was executed, the accounting issues and root of the issue, how it was exposed, the results to the company and its officers, and warranted ramifications as an outcome of the scandal.

The dystopian novella, Anthem, is set in an age in which every aspect of life is controlled by oppressive leaders. In this society, everyone was deemed equal to each other, meaning no new ideas were allowed and the past could not be discussed. Individuals are told they exist only for the sake of serving society and have no other purpose. Strict rules were put in place involving everyone’s daily lives, their partners, and even when they were allowed to smile. The goal of this controlling environment is to be completely free from conflict and maintain peace and order by giving citizens little freedom.

The story of Anthem takes place in some unspecified future in which freedom and individual rights have been obliterated. Equality 7-2521, the protagonist, is a street sweeper who finds a tunnel where he conducts his science experiments. Throughout the book we see him change and move towards individualism as he discovers how capable he really is. Ayn Rand uses vast amounts of literary devices to describe the evolution of Equality 7-2521. In the dystopian novella, Anthem, Ayn Rand expresses epochal symbolism and poetic personification in order to passionately display the individual’s superiority over the collective.

It has been one year since the implementation of the Patient Protection and Affordable Care Act, also known as Obamacare. Despite countless Republican attempts to repeal all or part of the new law, it is still with us and shows no sure signs of disintegration. The rollout of the government’s health care exchanges experienced significant growing pains right from the beginning. Time has fixed many of these technical glitches, but has done little to quell the debate over the affordability and viability of the law.

AARP, American Association of Retired Persons, is considered by Human Events as one of the most powerful lobbies. Many websites state that the focus of AARP is not the seniors, nut the money involved. The tactics the AARP are considered “scare tactics.” American Association of Retired Persons used scare tactics by scaring the seniors into thinking their Medicare benefits were going to be taken away from them by congress without their support. Obamacare was highly supported by the members of AARP, why? The AARP convinced its members without Obamacare their Medicare would be reduced. However, this was not the case, it did not protect Medicare benefits, and it actually cut 500 million each year.

Medicare and Medicaid fraud has some strengths as well as weaknesses. A strength that comes with healthcare fraud is The Affordable Care Act. This act helps to fight health care fraud, abuse and waste (Department of Human Services, 2014). Many laws have been implemented to help commit those people that have been committing Medicare and Medicaid fraud. Per the Center of Medicare and Medicaid services website “The Affordable Care Act increases the federal sentencing guidelines for health care fraud offenses by 20-50% for crimes that involve more than $1 million in losses, establishes penalties for obstructing a fraud investigation and makes it easier for the government to recapture any funds acquired through fraudulent practices” (Department

Blue Cross and Blue Shield of Illinois (BCBS) is considered the largest and most experienced insurance company in Illinois. BCBS was founded in order to provide healthcare to teachers at a reasonable cost. It services over 7 million people. Its mission is “To promote the health and wellness of members and communities through accessible, cost-effective, quality health care” (Blue Cross Blue Shield, 2012). Blue Cross Blue Shield provides its customers with affordable health care. The parent company is Blue Cross Blue Shield Association its signature tag is “Creating Healthier Communities,” BCBS does not have any investors and the customers are considered the investors of the company and essentially who BCBS answers to. This is an important factor because they do not have to keep investors interest in the forefront of decision making, but rather they have the interest of their client in mind. (Blue Cross Blue Shield, 2012) In 2013 the Chicago based company reported profits of 684.3 million dollars. The company employees over 17,000 people. “Blue Shield of Illinois fell well below the $1 billion mark for the first time since 2009, in part because the insurance giant is setting aside money to offset expected losses from the troubled rollout of Obamacare” (Wang, 2014). Despite this setback it continues to expand over various parts of the United States. BCBS

Anthem’s previous strategy, which focused on cost leadership, was supported by numerous factors including their high brand recognition through the Blue Cross Blue Shield network. However, because of the post ACA environment and novel payment models, the company is shifting towards a differentiation strategy. Their new strategy focuses on the following objectives: (Anthem website)

Anthem Inc, a leading health insurance company that provides health insurance for personal, business and government entities across the States. Anthem is a prosperous company, ranking within the Fortune 50 list, with total assets equaling $61.7 Billion. They have over 52,000 associates to serve over 39.8 million members. The company has presence in 14 States and continues to offer its services in growing markets (“Stats and Facts”).

The Target data breach remains one of the most notable breaches in history, it was the first time a CEO of a major corporation was fired due to a security event. The breach received an enormous amount of attention, it caused corporations and individuals to change the way they think about information security and data protection. Between Thanksgiving and Christmas 2013 hackers gained access to 40 million customer credit cards and personal data of 70 million Target customers. The intruders slipped in by using stolen credentials and from there gained access to vulnerable servers on Targets network to launch their attack and steal sensitive customer data from the POS cash registers. All this occurred without a response from Targets security operations center, even though security systems notified them of suspicious activity. The data was then sold on the black market for an estimated $53 million dollars. However, the cost to Target, creditors, and banks exceeded half of a billion dollars. This report will review how the infiltration occurred, what allowed the breach to occur including Targets response, and finally who was impacted by the security event.

As a leading insurance company, Aetna’s primary market broadens to reach those who work full time or part time based on hourly wages through its subsidiary company, Strategic Resource Company (SRC) which was bought by Aetna, Inc in 2005 (SRC: Our Mission, 2012). Aetna’s fourth subdivision target market, which is considered the biggest subdivision, is providing insurance to “employers, third-party administrators, commercial insurance companies and other health plans (Aetna Subsidiaries, 2012)”. These latter targets are aimed at through Aetna’s fourth subsidiary Cofinity which includes over 2.5 million members as of 2009 (About Cofinity, 2009). Besides targeting health insurance consumers, Aetna aimed at a target market that excludes health insurance seekers yet includes health care providers. Through a fifth subsidiary, Medicity, Aetna created another target market subdivision where it can provide health information technology in health care facilities such as hospitals and practices (About Medicity, 2012). Finally, Aetna aims at acquiring shareholders and therefore targeted a market of

Insurance companies and the federal government should pool resources using a percentage of profits to finance a task force to arrestively fight fraud. The penalty for fraud should be more stringent which will cause perpetrators to think twice before formulating a plan to commit fraud. The Affordable Health Care Act is the beginning of many programs established to fight against fraud. Health care fraud is a growing problem and should be taken more seriously by citizens of the United States. Physicians, health care workers, and patients are responsible for

In a statement released on 6th February, 2015, Anthem Inc, the largest for profit managed healthcare company in the Blue Cross and Blue Shield Association released a statement that they were target of very sophisticated external cyber-attack. Apparently attackers gained unauthorized access to Anthem’s IT system and have obtained personal information of their current and former members such as their names, birthdays, medical IDs/social security numbers, street addresses, email addresses and employment information, including income data. Highly confidential information of as many as 80 million individuals was compromised in what is the largest known breach of a healthcare company. According to Bloomberg experts, Anthem first detected unusual activity inside its network on Jan. 27, 2015 and verified the intrusion on Jan. 29, 2015. The company has yet to disclose when the initial intrusion began. Anthem CIO, Thomas Miller informed a leading journal that “the attack was first noticed when an administrator found that his database identifier code was being used to run database queries that he hadn 't launched. He says the company 's investigators found that the data had been exfiltrated to a popular online storage site”. According to the study which was conducted by a firm, U.S. and

The main issue at hand was the Department of Health and Human Services didn’t pay the full percentage that was applicable under the risk corridor, which bankrupt some insurance providers. These small changes slowly deteriorate the free exchange market the affordable care act was built upon. The CEO Kelly Crowe of National Alliance stated “few businesses can sustain hits like the CO-OPs and other small and new insurance companies have endured” because of the federal government’s

On March 19 of the year 2003, Securities and Exchange Commission brought the trading of HealthSouth to an end on the New York stock exchange, charging the company for inflating its earnings by more than 10 percent and overstated its profits by more than $2.5 billion between 1999 and 2002. HealthSouth’s trading reached to $30.81 in the year 1998, but ever since the trading of the company has been put to an end it reached to $3.91 per share. One week later, Owens pleaded guilty to changing and editing the company’s financial statements.