Health Care Fraud Essay

1823 Words 8 Pages
Summary and Conclusion
This study sought to answer three research questions. Although the questions have been presented in previous chapters, they are worth presenting again.
 What are the major federal laws and policies related to health care fraud?
 How have these laws and policies been used to control fraud, waste, and abuse in federal health care programs?
• What are the impacts of these laws and policies on the war against health care fraud?
To address the questions comprehensively, the researcher conducted a historical research that blended the research elements of documentary research and content analysis. The use of historical research provided opportunity to travel through time and trace the origin and evolution of
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After establishing Medicare and Medicaid in 1965, Congress saw the need to protect the programs from fraudulent activities and practices of unscrupulous providers. The laws on health care fraud were enacted at different time during the history of the health care programs. However, the overall congressional intent has been the same, and the objective is to strengthen existing laws to protect the federal government health care programs from fraudulent activities. Although Congress has used several anti-fraud measures to protect the federal government health care programs, the False Claims Act of 1986 has become the main weapon that government prosecutors use against perpetrators of health care fraud. Designed to prevent fraud and other abuses in federal government programs, the False Claims Act has been the primary statute the government has used in its fight against health care fraud. However, government prosecutors do not rely on one statute in their prosecution of alleged cases of health care fraud. Instead, they rely on a combination of statutes, but the False Claims Act has emerged as the main statutory weapon.
Congress had amended the Medicare and Medicaid laws severally since their enactment in 1965. The Medicare-Medicaid Anti-Fraud and Abuse Amendments of 1977 were the first significant policy initiative Congress took to prevent fraud and abuse from Medicare and Medicaid. The 1977 amendments were specifically designed to

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