DISCUSSION BOARD PART 7-1 - Essay Example

Vanasco, R. R. (1998). Fraud auditing. Managerial Auditing Journal, 13(1), 4-71. Retrieved from http://search.proquest.com/docview/274706011?accountid=45049 Vanasco looks deeper into the role played by various institutions and professional associations such as government agencies and auditing bodies in setting up standards which are used to detect fraud in various capacities such Medicare, insurance, and banking industry. The main motive of this survey is to show the mixed method research survey of the level of Medicare in the US.

Vanasco notes that Medicare fraud involves theft such as taking money, assets, or information, concealing the information, money, or assets obtained in order to hide the fraud from other concerned parties, and converting the stolen assets into cash. Moreover, he notes that GAO has estimated the total loss per year to Medicare fraud and abuse to amount to US$47 billion, which is 10 percent of overall Medicare expenditure in the US. Stanton, T. H. (2001). Fraud-and-abuse enforcement in Medicare: Finding middle ground.

 Health Affairs, 20(4), 28-42. Retrieved from http://search.proquest.com/docview/204639339?accountid=45049 According to Santon, Medicare fraud and abuse draws many resources from the Medicare scheme at a time when there are limited resources. He aims at finding a middle ground since there is a budding for savings because of rigorous exertions to bring to a halt fraud and abuse in Medicare. The question derived from his research is “Can there be a middle ground in Medicare and fraud laws?

” However, he notes that care must be taken in order to report the authentic concerns of suppliers caught in an antagonistic antifraud net. In addition, he notes that a good time must be provided in order to contemplate the intrinsic worth of finding a middle ground. His mixed method research notes that fraud and abuse are grave problems that gutter resources from Medicare at a time when means are scarce. This kind of provider backlash results from lack of consensus from the congress and therefore the congress should provide limits to the kind of excesses that provoke the entire Medicare project into anger.

He further recommends steps to be taken to prevent fraudulent activities and provide legitimate providers to conduct their services. His qualitative research recommends the creation of a law that will address these kinds of concerns. An example of such a law is the False Claims Act and the Health Insurance Portability and Accountability Act (HIPAA) of 1996. This act permits private citizens to take legal action on behalf of the government and to get a certain fraction of any recovered funds. This act applied to Medicare and Medicaid.

Hollis, M. (2005). Experts fear more fraud if Florida’s Medicaid system is privatized. Knight Ridder Tribune Business News. Retrieved from http://search.proquest.com/docview/460380850?accountid=45049 Hollis notes that several legislations have been put in place in Florida to allow laws to guard the healthcare subscribers. He further notes that without a proper safeguard into the Medicare program, the risk of Medicare frauds would even increase. This led him to conduct a mixed method research in Florida’s Medicare program.

In his research, he notes that Florida loses $1 in every $10 invested. This is a large sum considering that it reflects 10% of the sum invested. According to the statistics