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Essay / Research Paper Abstract
A 5 page paper summarizing the contents of a fraud and compliance training presentation. Errors can occur quite innocently, resulting in inaccurate billing that has no fraudulent intent behind it. As the presentation indicates, however, fraud, waste and abuse are the same regardless of whether they are committed intentionally. Bibliography lists 4 sources.
Page Count:
5 pages (~225 words per page)
File: CC6_KShlthCrFraud.rtf
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Unformatted sample text from the term paper:
difficulty in devising a corporate compliance plan is the complexity of overseeing one highly complex and detailed activity (health care) so that it complies with extensive government regulations. Errors
can occur quite innocently, resulting in inaccurate billing that has no fraudulent intent behind it. As the presentation indicates, however, fraud, waste and abuse are the same regardless of
whether they are committed intentionally. Definitions The entire area of fraud, waste and abuse also is referred to as "FWA." The terms
are specific. * Fraud. "The intentional deception or misrepresentation to get an unauthorized benefit" (Presentation Lesson 1 p. 1). * Waste. "The over-utilization of services, or other practices
that result in unnecessary costs" (Presentation Lesson 1 p. 1). * Abuse. "Acting with gross negligence or reckless disregard for the truth in a manner that could result in
an unauthorized benefit" (Presentation Lesson 1 p. 1). The definition given for fraud early in the presentation specifically states that there is intent
to defraud involved in the fraudulent action. Some pages into the presentation, however, there is a statement that an individual can commit fraud without necessarily intending to do so.
Further, there are some instances that the government would label practices as being fraudulent when they are not, or are fraudulent only within
the definition when it is associated with a government program. As example, physicians and others (such as chiropractors) who provide uninsured patients "discounts" for paying in cash at the
time of service risk being charged with and prosecuted for fraud if they also treat Medicare or Medicaid patients that do not also receive the discount. Though these practitioners
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