Health Care Abuse Essay

One of the main ethical issues that faces health care is the security of patient information. This information is protected by laws and regulations such as HIPPA, but there are still concerns Scott, et al, 2005). Among those concerns is the new concept of electronic patient records and information. These records are designed to help hospitals and doctors get patient information more quickly, so that patients can receive treatment as soon as possible. Unfortunately, anything kept and transmitted on a computer has the potential to be hacked, so that is a serious concern for patients. Not all patients want their medical records to be available electronically, but they may not have too many options (Romano & Stafford, 2010). Opting out may not be an option for them, and if they do have that option it could reduce the speed and quality of treatment that these patients would receive. Do they want to risk that, just so they can feel as though their medical information is better protected?

Title II of HIPAA covers two main areas: preventing healthcare fraud and abuse, and a broad series of rules under the framework of administrative simplification. The first area is not of significant interest to most healthcare workers. It defines numerous offenses relating to healthcare, and authorizes several programs to attempt to find and control fraud and abuse. Nurses should be aware of the proper procedures for reporting fraud and abuse at their facility. The second portion of Title II—administrative simplification—however, contains five separate rules, most of which have already had a significant impact on virtually everyone working in American health care, including all those working in any way with health information concerning

Although the discussion focuses on the risk manager, most large health care organizations employ a team of individuals to reduce the risks of loss and increase patient safety from both a proactive and reactive stance. The health care environment is constantly evolving, but nothing has made change as pervasive as the Patient Protection and Affordable Care Act (PPACA) and the regulatory and compliance mandates contained within its wording. For instance, maintaining confidentiality of patient information, a key function of risk management, is now more difficult with the rise of cybercrime of medical information. According to Finkle (2014), the Federal Bureau of Investigation warns health care providers there is high demand for medical information by criminals to commit both impersonation crimes and financial fraud. These concerns were unheard of not long ago. Confidentiality and protection of patient information is only

For us to be able to define abuse, I think we should look into the dictionary to see the meaning of the word ABUSE.

2. Think of an example of a time you have received feedback from others than has improved your knowledge, skills and understanding. This may have been from your assessor, tutor, a supervisor or line manager, or individuals using the service. Description of experience How did this experience improve your knowledge, skills and understanding?

fraud risk exclusion from participation in Federal health care programs and the loss of their

You’re sitting at home one afternoon, three weeks prior to the start of Open Enrollment, when you get a call from a friendly Center for Medicare Services (CMS) employee. The caller tells you that Medicare is issuing “new cards,” and that you need to provide your Medicare number, birth date and social security number in order to get yours. The catch? The caller doesn’t work for CMS, and he’s actually trying to steal your identity. Elder abuse is one of the most common crimes of the 21st century. In fact, studies have shown that 2 in 10 older adults have been financially exploited. Read on for 5 tips on avoiding common types of Medicare scams.

We have recently learned the Department of Health and Human Services is investigating Houston Methodist for Medicare fraud. We will cooperate with and respect the officials conducting the investigation and are confident we will be exonerated of all allegations. We believe that we will be found innocent once the investigation is complete.

Medicaid fraud is illegal, but it is still big business. According to the Office Of Management and Budget, Medicare made nearly $47.8 billion improper payments in 2010. This is nearly 10 percent of the $528 billion spent on Medicare. The United States cannot afford to keep dealing with this type of fraud.

Deciding to step up and report Medicaid Fraud is an honorable thing to do. It is also an action that while noble is not easy. While difficult getting a qualified, knowledgeable fraud attorney is the right course of action.

As we head into the next four years under the Obama administration, many Americans are hearing more and more about healthcare reform and what needs to be done to fix the ailing healthcare system. Part of the dramatic increase in healthcare costs is due to Medicare fraud abuse. Healthcare fraud is defined as making false statements or representations of material facts in order to obtain benefits or payment. Healthcare abuse is defined as practices involving the overuse or misuse of services, either accidentally or intentionally, for various reasons that results in overpayment. These acts may be committed by an individual person or an entity. Fraud and abuse exposes a person, provider, or entity to criminal and

The table below sets forth HCFAC funding, by agency, for health care fraud and abuse control activities in FY 2014, including sequester reductions. The FBI also receives a stipulated amount of HIPAA funding for use in support of the Fraud and Abuse Control Program, which is shown below. Separately, CMS receives additional Mandatory Resources under the Medicare Integrity Program (section 1817(k)(4) of the Social Security Act). The inclusion of the activities supported with these funds is not required in this report, and this information is included for informational purposes.

     It is unfortunate that in our society some children grow up without the opportunity of having a loving family to raise them. More unimaginable is children growing up with parents or family members that are abusive. Children raised in abusive environments that are reported to social services and removed from their home are placed into foster care. Foster care is defined supervised care for delinquent or neglected children usually in an institution or substitute home set up by the government. Some advocates claim that the government child care system is adequate, but others like David Van Biema of Time Magazine state that, “foster care is intended to protect children from neglect and abuse at the hands of

The VA does not pay for all of those visits. The US Government is sending The Department of Veterans Affairs funding warnings and they are not paying attention to them. “The Veterans Health Administration who provides health care to about 8.8 million veterans a year, has ignored warning about its deficiencies” (“The US Veteran Health Care System Is Overwhelmed and Failing”). President Obama ordered a review of this issue that offered help and suggestions (“The US Veteran Health Care System Is Overwhelmed and Failing”). The United States Government is trying to help out the Veterans Association by sending them warnings and suggestions. The VA is not acting upon them. They are sitting back and just playing it out. They need to step in and act

Another effective way of controlling healthcare fraud and abuse is through reinforcement of federal penalties, enforced by the department of Health and Human Services. For example, in the year 2011, the US department of Health and Human Services committed approximately $248 million in the fight against fraud and abuse. This extraordinary effort resulted in a significant increase in the number of cases prosecuted, amount of money recovered, and the dollar amount of claims filed. The federal government can assist healthcare overall fight the abuse and fraud by being assiduous in prosecuting the providers, the healthcare organizations, and individuals who commit fraud and abuse in an organized and systematic manner, not sparing anyone, because