Question

Please describe fraud abuse found in healthcare and the impact it has on healthcare policy and practice?

Answer 1

Now a days the fraud abuse in the health care setting are increasing in the various level.

fraud abuse is the dishonest act that as committed with knowledge that provide unauthorised benefit to the person who is comitting the action.

Various fraud abuse found in health care

* Misrepresentation of the type of services or the level of services which is provided to the client .

* Billing for the services which are not provided

* Billing for the services which are not medically necessary

* Providing over treatment to the client

* Converting a non covered services into covered services .

* Billing for services that are not properly been documented

* Selling prescription drugs or the supplies which is obtained under healthcare benefits .

* Loaning or using another person health care card to get medical services .

It is estimated that about billions of dollars are losing annually due to fraud abuses in the health care .The ​​​National Health Care Anti-fraud Association estimates that about 68 billion dollars are losing annually as a result of fraud abuse in health care .

The fraud abuse found in the healthcare cause various impact on the healthcare policy and practise .

The impact of fraud abuse on healthcare policy and practise .

About billions of dollars are spending for healthcare ,representing billions of health care claims and the reality behind this is most of the claims are fraudulent .

Those fraudulent claims carry a high price tag ,both financially and in how they impact our perception regarding the value of health care system.

However the financial loss caused by the fraud abuse is only the one side .we can easily found many people with sad face who are the victims of health care fraud and abuse .

Fraud performance toward the Medicaid and Medicare insurance system directly drains the tax payers of the country .as more funds are needed as a result of fraud abuse in health care ,the taxes gets raised ,this will effect everyone who is employed .

So it is clear that the fraud abuse in the health care cause great impact on the healthcare policy and practises