Current Health Care Issues

1459 Words Nov 11th, 2011 6 Pages
Current Health Care Issues

HCS/545

Camille Fuller

University of Phoenix

The health care industry exist to provide preventative measures, diagnose health conditions, repair, and provide services to improve the quality of life. The cost of health care continues to rise each year. Health care fraud is a factor that continues to plague the health care industry. The affect health care fraud has on hospitals, is the increasing cost of medical services. The following research will examine and evaluate how organizational structure and governance, culture and the lack of focus on social responsibility affects on health care fraud. The following research will also include recommendations for prevention of health care fraud, recommendations for
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The previous organizational structure for payment of services rendered did not allow officials enough time to investigate claims to ensure the claims were legitimate. Perpetrators study the law and use the knowledge to fraud insurance and government agencies. The governance of rules, regulations and laws was not stringent enough to stop perpetrators from frauding the system. New guidelines allow agencies more time to detect suspicious claims, investigate and save the insurance companies millions of dollars. Society does not concentrate on proactive actions to prevent fraud, instead society deals with the problem after the fact. Consumer watch groups do not have tools in place to prevent fraud. Perpetrators rely on the oversites of insurance companies in order to target and fraud insurance companies.
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

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