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Essay / Research Paper Abstract
This 5 page paper provides an overview of the False Claims Act and relates it to Medicare fraud. Specifically, this paper considers whether or not the FCA is an effective deterrent to crime. Bibliography lists 5 sources.
Page Count:
5 pages (~225 words per page)
File: MH11_MHFalse33.rtf
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Unformatted sample text from the term paper:
a focus on the issue of Medicare fraud has resulted in an increased application of legal doctrine devised to support the False Claims Act (FCA) in reducing Medicare billing fraud.
More specifically, the Balanced Budget Act of 1997 and the Health Insurance Portability and Accountability Act of 1998 were both developed to strengthen the FCA relative to the issue
of fraudulent Medicare billing (Texas Legal Center, 2001). Even so, as much as 10 percent of all Medicare billing is intentionally fraudulent, and constant efforts by the government to
recover lost funds have resulted in costly legal pursuits (Hawryluk, 2004). In fact, in 2003, the False Claims Act was applied in the recovery of over $2 billion, $1.48
billion of which was the result of investigations following tips from whistleblowers (Hawryluk, 2004). Though it is evident that legal directives are in place to address the issue of
Medicare fraud, the question that arises is whether or not the legal directives for appropriate participation in Medicare and their punitive elements are effective deterrents to the crime. If
the law is clear, applicable and valued, why, then, does fraud persist? The answer: Medicare fraud persists because the cost of successfully circumventing the system and securing fraudulent
payments is more lucrative then the financial "risk" of being caught. Like any crime, if the law is lax in either the presence of legal directive or its enforceability,
criminal behavior will continue. It is not the language of the law itself that is unclear. Under the FCA (31 U.S. C. sect. 3729), provisions are made for the
application of penalties and damages for intentional fraudulent or false claims that result in payments by the U.S. government. The law prohibits either the "making of a false record
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