Medicare Fraud & Abuse Report
According to the Center for Medicaid and Medicare services over 70.4 million people
were enrolled in these programs in 2011 (Jeffery, 2012). Medicaid is the public insurance
program that
...
Medicare Fraud & Abuse Report
According to the Center for Medicaid and Medicare services over 70.4 million people
were enrolled in these programs in 2011 (Jeffery, 2012). Medicaid is the public insurance
program that provides coverage to low-income individuals and their families (Park, 2015).
Medicaid is known for dramatically cutting the number of uninsured Americans in half,
improving access to care for individuals with chronic conditions and providing financial support
to their low-income beneficiaries (Park, 2015). Medicare is a health insurance program that pays
for a variety of health care expenses. Medicare beneficiaries tend to be ages 65 and older with
certain medical conditions or permeant disabilities (eHealth, 2017). There are four types of
Medicare programs that are know as Medicare Part A, Part B, Part C & Part D. The difference
between these four programs range from monthly copays to coverage & drug prescriptions.
Although these two programs have been known for saving millions of people money on
their medical expenses there are individuals, both patient’s and providers, who use the services
and the funding for personal advantage. Medicare and Medicaid fraud and abuse are a growing
problem here in the United States. With the rise of opioid addiction and the hunger of the drug
cartels to make money off it, millions of individuals have learned how to execute a scheme to
obtain money or property from these health care programs. In addition, some health care
providers have performed actions that have directly or indirectly resulted in the unnecessary cost
of benefit programs. In this essay I will briefly discuss two cases of falsifying supporting
documents which are relevant cases of fraud and abuse that are seen most often in the 21st
century.
[Show More]