Fraud in the Health Care System
By Jorge Hiram Garcia, Your Insurance Advisor | April 30, 2010
One good benefit coming from all of the attention being paid to health care reform is the attention being paid to fraud in the medical health care community, much of it perpetrated by health care providers. Many people oppose the reforms fearing a turn to socialist policies by the government. Where there is controversy, however, there are a lot of spotlights turned on, and in this case all of the light is turning out the rats hiding in the dark.
Daniel Levinson, the inspector general of the U.S. Department of Health and Human Services, predicted earlier this month in a meeting of the Health Care Compliance Association that there will be an emphasis in quality measurement from health care providers.
The new federal Affordable Care Act – a package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act – ties some payments to physicians, hospitals and other care providers to the quality of care provided – Levinson
By itself, the new regulations will not change much. The new regulations will require health care providers to provide additional documentation and reports as to the quality of and type of care provided. If legislators can tie those changes into increased oversight, and actual inspections to see if the documentation actually reports what care was provided, they might be able to clamp down on some of the fraud going on. Normally, knowing that something like this will create an even larger bureaucracy, i.e. even bigger government, I would be completely against it, but seeing how much fraud goes on simply from what I hear back from consumers that use their health insurance, makes me believe that, at least in this case, the resulting bureaucracy might actually be of some benefit, however limited that benefit may be. Hopefully it will at least be a step in the right direction.
Levinson further addressed fraud in his speech by highlighting the amount of fraud going on in the MediCare system.
In some cases, “viral” Medicare fraud schemes are replicating rapidly through ethnic and geographic communities, and, in some cases “violent criminals” are infiltrating the Medicare program – Levinson
…sham providers defraud Medicare by masquerading as legitimate providers. – Levinson
It’s shameful that the system created to care for seniors should be so easy for criminals to infiltrate and abuse. Let me know what you think about this type of abuse in the health care system. Have you run across any instances of blatant criminal activity or corruption in the health care system aimed at defrauding insurance companies or government provided health care assistance?
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=ba30226c-0b97-42e9-98a8-4f90d12f0e20)
1 Comment
Pingback: Tweets that mention Fraud in the Health Care System » Your Insurance Advisor -- Topsy.com