Medicare Fraud Essay

2910 Words Mar 22nd, 2013 12 Pages
Medicare Fraud: The History, Incidence, Costs and Institutional Remedies
John H Everett
Wayland Baptist

Medicare Fraud: The History, Incidence, Costs and Institutional Remedies What is Medicare fraud? ("F&A," 2011, p. 1) states “Medicare fraud happens when Medicare is billed for services or supplies you never got. Medicare fraud costs Medicare a lot of money each year.” What is Medicare abuse? ("F&A," 2011, p. 1) defines this as “Abuse occurs when doctors or suppliers don’t follow good medical practices, resulting in unnecessary costs to Medicare, improper payment, or services that aren’t medically necessary.” In reviewing the definitions of fraud and abuse by Medicare it may be hard for some people to
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The total settlement for this case was $1.7 billion. ("HCA," 2003, p. 1) “This settlement marks the conclusion of the most comprehensive health care fraud investigation ever undertaken by the Justice Department, working with the Departments of Health and Human Services and Defense, the Office of Personnel Management and the states. The settlement announced today resolves HCA’s civil liability for false claims resulting from a variety of allegedly unlawful practices, including cost report fraud and the payment of kickbacks to physicians.” This case started back in 1997 and took almost six years to complete. So, if one can imagine for the whole time your company’s name and reputation is publicized almost daily. Can you imagine the effect it had to each of its 300 hospitals? I can, fortunately or unfortunately I was with HCA during this time and I got to spend a lot of it helping various hospitals with subpoena requests. If you have ever since a good size board room full of boxes, it is very amazing and scary to look at. Also, to actually know some of the people who were charged and sentenced to jail, this will turn your world upside down. It was nice to find out all of these cases were over turned and the people were freed from jail, but still their lives, their families were totally destroyed. I can tell you from

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