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Essay / Research Paper Abstract
A 3 page paper. Health insurance fraud is estimated at over $150 million per year, more than 10 percent of all health care bills. This essay reports the laws that deal specifically with Medicare fraud, e.g., the False Claims Act. The writer then proposes the laws are clear but fraud persists because there are not enough investigators to keep up with it. Bibliography lists 7 sources.
Page Count:
3 pages (~225 words per page)
File: MM12_PGmdc3.rtf
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Unformatted sample text from the term paper:
final thesis extremely difficult for you. I would suggest you turn the question around to something like "what health care organizations can do to decrease or eliminate fraudulent billing practices.
There are dozens of examples of how hospitals and other agencies are taking steps to assure they do not violate the laws. -- just a suggestion for a much easier
paper to research. You could still use the substance of the papers we have written but just make the problem statement something like I suggested above or "strategies health care
organizations can use to prevent fraudulent claims or billing or something like that. This particular paper (order 515250) requires only pulling certain parts of the two previous papers and integrating
them with a clear problem statement at the end.] Health insurance fraud and abuse is estimated at $150 billion per year in the United States (Managed Healthcare Executive,
2004). In terms of the actual annual amount spent on health care, that means more than 10 percent of the payments are fraudulent (Managed Healthcare Executive, 2004). Fraud occurs with
Medicare and Medicaid programs as well as private insurance programs (Albert, 2004). For example, the state of California estimates fraudulent billing costs in the Medi-Cal program total as much as
$3 billion annually, that is about 10 percent of all claims (Albert, 2004). There are a number of laws that specifically address fraudulent billing practices. The False Claims Act (FCA)
was enacted decades ago, during the Civil War to "control fraud" in federal contracts" (National Whistleblower Center, 2005). This Act was amended in 1986 to include protection for whistle-blowers (Hawryluk,
2004). The amendment at least increased the number of cases reported and the subsequent prosecution of those cases (Hawryluk, 2004). In 2003, for instance, the Federal Government recovered $2.1 billion
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