The Issue Of Healthcare Fraud And Abuse

1598 WordsDec 15, 20167 Pages
The purpose of this paper is to bring awareness to the issue of healthcare fraud and abuse. I feel that healthcare fraud and abuse is one of the biggest issues in healthcare. So, this paper will get everyone to be able to spot fraud before it happens. During, the process you will be able to identify what a person organization did that was fraud or how they abused healthcare rules. This paper will explain to you what exactly healthcare fraud and abuse is and how it affects everyone around us. Throughout this paper, we will examine 3 different articles related the healthcare fraud and abuse and provide a summary and analyze them. So, what is healthcare fraud and abuse is, you may ask? When talking about healthcare fraud and abuse, we are talking about 2 major statutes in the healthcare industry, Physician Self-Referral (Stark) Law and AKS (Anti-Kickback Statutes). These laws apply to many practices and procedures within organizations and can be manipulated to benefit an organization financially. The Physician Self-Referral Law prohibits entities from presenting a claim to anyone for healthcare services for a service not rendered and it also prohibits a physician for creating a referral for services that are designated but are not rendered. AKS prohibits anyone from offering a kickback, paying a kickback, or receiving a kickback in return for the delivery of health care services. However, the AKS encourages referrals based on monetary rewards to the primary source rather than

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