Healthcare Fraud : The Affordable Care Act
1610 WordsApr 26, 20167 Pages
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…show more content… Another strength for the fight against fraud is the formation of the different teams, groups and organizations to help combat Medicare and Medicaid fraud. Among those that we started to alleviate the amount of fraud that has happened are; Office of Inspector General (OIG), the Healthcare Fraud Prevention and Enforcement Team (HEAT) and the General Services Administration (GSA). According to the Department of Health and Human Services “the OIG protects the integrity of HHS’ programs, including Medicare, and the health and welfare of its beneficiaries” (Department of Health and Human Services, 2014). The OIG carries out its duties through a nationwide network of audits, investigations, inspections, and other related functions. HEAT was established to build and strengthen existing programs combatting Medicare fraud while investing new resources and technology to prevent fraud and abuse. HEAT created the Stop Medicare Fraud website which provides information on how to stop and protect yourself and others from Medicare fraud as well as how to report fraud. The last system that was created was GSA which has strengthened the fight again fraud by converging several government groups into one group known as SAM or System for Award Management. According to the Department of Health “SAM includes information on entities debarred, suspended, proposed for debarment, excluded, or disqualified from receiving Federal contracts or certain subcontracts and from certain