Health Care Fraud And Abuse Research Paper

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Health Care Fraud and Abuse Health Care Fraud and Abuse 2013 Kelly Oakley Professor Tomlinson Healthcare Law HC-310 3/7/2013 2013 Kelly Oakley Professor Tomlinson Healthcare Law HC-310 3/7/2013 “Today’s enforcement actions reveal an alarming and unacceptable trend of individuals attempting to exploit federal health care programs to steal billons in taxpayers’ dollars for personal gain,” stated Attorney General Holder (Department of the United States Justice Department, 2012). The Obama Administration has made an effort to enact new anti-fraud provisions in the Medicare, Medicaid, and CHIP (children’s health insurance program) programs (U.S. Dept. of Health and Human Services, 2010). The Affordable Care Act has issued many new…show more content…
They have teamed up with Centers of Medicaid & Medicare Services, Department of Health and Human Services and Department of Justice. Under the Affordable Care Act, CMS has developed new provisions in an effort to reduce fraud and abuse. They have mandated tougher sentences for criminals who commit fraud, developed new state of the art technology to make it harder for criminals to commit fraud, and implemented a provider screening system that will enhance screening requirements (HealthCare.Gov, 2011). “Thanks to the new law, we will now have the resources that will enable us to do more to prevent fraud and stop criminals from getting into the system in the first place,” stated CMS Administer Donald Berwick (U.S. Dept. of Health and Human Services,…show more content…
Enhanced provider screening was another area of focus in the Affordable Care Act. “Providers and suppliers wishing to participate in Medicare, Medicaid, and the Children’s Health Insurance Program who may pose a higher risk of fraud or abuse are now required to undergo a higher level of scrutiny” (HealthCare.Gov, 2011). The Affordable Care Act is not only taking steps to prevent fraud, but is enforcing sticker and tougher sentences on fraudulent criminals. There has been a 75 percent increase of individuals charged with criminal healthcare fraud and they will now receive a 20 to 50 percent longer sentence for crimes’ involving more than $1 million in loses (HealthCare.Gov,
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