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Health Care Economics - Research Paper Example

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This research paper describes the economic value of the health care industry today that is a topic of prime importance that has genuine relationship with the other industrial sectors of the economy. It also focuses on exploration of the implications of the cost of health care fraud…
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Health Care Economics
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Download file to see previous pages on and use of drugs that they don’t even need and also the other side.(CULS, nd) The example practices of health care fraud include billing for services that were not provided, intentional duplicate billing, erroneous prescription etc. Health Care Abuse; Health care abuse is the practice incurred for the sake of earnings out of prescriptions / applications that are not needed. The provision of goods and services that do not meet the standard of professional health care industry is health care abuse. The example of health care abuse include charging of unnecessary services or prescription of unwanted treatments etc Difference between Health Care Fraud and Health Care Abuse; the difference in health care fraud and health care abuse pertains with the nature of act. Hence, an act that results into unnecessary treatment / prescription falls under the category of health care abuse but the acts that deliberately aim to charge an extra cost out of cheating is counted in the definition of health care fraud. Waste; It refers to the provision of goods and services that were intended not to swindle or mislead but the payment methods that unintentionally raised the cost due to organizational errors. Rules and Regulations Related to Health Care related Fraud and Abuse; The various laws related to Health Care fraud and abuses are stated below for an overview; each of the below mentioned code followed by their clauses render a different impact on the case based on the execution. False Claims Act (FCA), 31 U.S.C., s. 3729 Florida False Claims Act, F.S. 817.234 Anti-Kickback Statute 42 U.S.C. s. 1320a-7b(b) Physician Self-Referral (“Stark”) Statute, 42 U.S.C. s. 1395nn Deficit Reduction Act of 2005 HIPAA of 1996, Title 18, Section 1347 Fraud Enforcement and Recovery Act of 2009...
This research paper explores the health care economic system of the United States and it's strategies as well as frauds problem that are becoming a widespread issue at present time that needs immediate attention of authorities for raising preventive measures. In the year 2008 the reporting of United States department of Health and Human service office of inspector general reveals the elimination of around 3,000 personnel against accusation of health care related fraud and abuse. Out of these 575 were criminal graded actions and 342 were the civil action abuses. The estimated loss mentioned in the research paper incurred out of the wastage was around $20.4 billion. Although the benefits of medications when used properly cannot be under estimated but the control of resources will grant the improvement in all the other sectors directly and indirectly. Evidence based training with the utilization of strategy that was proposed in this research paper will support the authorities to raise the potential of professional staff by rendering compact training with plans based on rationale of evidences. A thorough education of policies and procedures along with the training sessions in support of new practices induced via evidence based evaluation will aid the health care authorities to attain an improved level of control on health care delivery. The researcher states that a mutually cooperative exercise will not only aid the socio economic structure but will further improve the system by contracting the space for illegal practices. ...Download file to see next pagesRead More
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