The United States : A Multibillion Dollar Industry

1370 WordsJan 30, 20166 Pages
Healthcare in the United States is a multibillion-dollar industry. Over time, the number of elderly people which have fallen victim to Medicare and Medicaid billing fraud has sky rocketed at an alarming rate. The Elder Abuse & Nursing Home Neglect Attorneys refer to this as an “overbilling epidemic” (n.d.). This means that many elders are being charged more money for the services they are receiving or in some circumstances, paying healthcare providers without receiving any care. Since most of them are unaware of what they are being charged for or how much they should be charged, they are easily taken advantage of. Medicare and Medicaid, which were formed to help and maintain the health of people deviated from that over time into an…show more content…
Upon reading further into Medicare and Medicaid billing fraud, I have learned that there are many types of fraud. Doctors who commit fraud can do so in many ways, such as billing for services never received, performing unnecessary procedures, falsifying documents to perform more procedures, and even accepting money for patient referrals, among others. This signifies that some physicians are potentially physically harming their patients for their own financial benefit. Some providers, nevertheless, believe that they can “outsmart” the system and choose to overbill their elder patients. By overbilling their patients, it is harder for the government to keep track of that. However, with the Affordable Care Act, there have been new rules and regulations to avoid all types of fraud as much as possible. With the enactment of the Affordable Care Act, several organizations have begun bringing awareness to healthcare fraud and have fought to prevent it, some of which are the Health Care Fraud Prevention Partnership and Senior Medicare Patrols. Furthermore, the Affordable Care Act has taken many precautions to prevent fraud, such as using “fraud detection technology, enhancing provider screening and enrollment requirements, and having a greater oversight of private insurance abuses” (Centers for Medicare & Medicaid Services, 2015). Private insurers typically “lose an [estimated] 1%-1.5% of their revenue to fraud alone” (Health Research
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