Medicare And Fraud Essay
The Federal and State governments share the cost of Medicaid. Fraud, waste, and abuse in Medicaid drain taxpayer dollars and cause improperly high payment rate. Modern Healthcare reported (2015) that in 2014, the government reported nearly $80 billion misspent on Medicaid and Medicare. New York City is an example of local government struggling with Medicaid fraud; New York Times (2005) suggests that 40 percent of NYC’s Medicaid payments are “questionable”. Most of the reporting protocols are optional, and because reporting information consumes already-limited resources, many states choose not to report. Centers for Medicare and Medicaid Services (CMS) oversee the healthcare programs at the federal level. Recent legislation passed by Congress …show more content…
CMS applies the new technology to focus on fraud detection and provider enrollment (Ted Doolittle, 2010). The recent Time magazine (2016) report on an arrest of 275 people nationwide of a crackdown on Medicaid and Medicare fraud seems to explain a progress on implementing the new legislation. As the implementation runs in a slow speed and many flaws have been found by Office of Inspector General (Muchmore, 2016), Lawmakers question the CMS performance and suggest a reform Base on Medicaid data (CMS, 2016), since 2013, Medicaid enrollment has increased 25 percent with the implement of the Affordable Care Act (ACA) in 2010. Under the ACA, new eligibility requirements allow individuals who make less than $16,000 to enroll in government-sponsored health insurance without using asset test, which was previously used to determine eligibility in regular Medicaid; thus, …show more content…
Policymakers intend to introduce reforms, such as time limits and work requirements, to help break the generational cycle of dependency and encourage people moving up the economic ladder. Instead of welfare, a “workfare” hypothesis theory is
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Medicare Fraud Research Paper
301 Words | 2 PagesThese changes allow healthcare professionals to reap huge financial benefits for reporting Medicare fraud that is done by the healthcare industry. In some cases, people have been rewarded millions for reporting Medicare Fraud. People who report Medicare fraud are now able to receive up to 30 percent of the fines that are collected by the government. They are also able to receive full protection from retaliation. Hundreds of millions of dollars have been paid out by the United States government to people who have reported information about Medicare fraud.
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Affordable Care Act Essay
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Affordable Care Act
786 Words | 4 PagesMillions of Americans are constantly reminded of the horrible effects of the Affordable Care Act anytime medical care is required. I have witnessed many families and individuals struggle to cover the extra financial responsibility imposed upon them: Susan Gardiner, a fellow Kroger employee, states her health insurance costs have significantly increased following the approval of the Affordable Care Act; consequently, Ms. Gardiner routinely experiences financial hardships as she requires frequent medical care. Americans simply cannot cope with the Affordable Care Act’s inherent attribute of exorbitant insurance premiums and deductibles. In an attempt to decrease medical costs for an impoverished minority of Americans, the Affordable Care Act,
Medicaid Reforms
1437 Words | 6 PagesAfter the passage of the ACA, Minnesota was chosen to pilot a Medicaid program using ACOs to improve healthcare delivery because of the previous reforms that were made to the state’s Medicaid system. In 2008, the Minnesota state government passed the Health Care Reform Law which implemented the utilization of health homes to provide Medicaid services and a revision of the state’s quality and monitoring system of the Medicaid program (Edwards, 2013). The law was also expanded to use ACOs after the passage of the ACA, in order to provide more comprehensive care for Medicaid beneficiaries (Edwards, 2013). The use of the ACOs “forged a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care” for Medicaid beneficiaries (Sandberg, Erikson, Owen, Vickery, Shimotsu, Linzer, Garrett, Johnsrud, Soderlund, & DeCubellis, 2014). To ensure the success of the program, the state also developed a safety-net program to ensure that Medicaid recipients would continue to receive quality care to meet their health care needs, if the pilot program
Disparities In Health Care Essay
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