Medical Identity Fraud Research Paper

“Law enforcement and government officials are focused on the “war on drugs.” But illegal drugs are not the only problem society is facing. In today’s fast-paced, stress-filled world, millions are becoming increasingly dependent on prescription drugs. Often, people are looking for the “quick cure” for all ailments, from headaches to heart disease.” (Medicated). What they are referring to is that they are really not trying to help the problem of the prescription drugs epidemic, because if they were going to try to help it first things first they would have to get rid of all the advertisements on the TV for the prescription

These cyber threats have made most of healthcare's trusted technology less reliable and there is a race to find solutions. Issue Education According to the Solutionary, an NTT Group security company, "the healthcare industry was the victim of 88% of all ransomware attacks in U.S. industries last year and 89% of studied healthcare organizations have experienced a data breach, which involved patient date being stolen or lost over the past two years. These health data breaches have cost the healthcare industry in America alone an estimated $6.2 billion, according to the Ponemon Institute. Health systems are such an

It caused severe problems within our public health system as well. According to Patel & Rushefsky (2005), “the AIDS epidemic in the 1980s caused the public health system to fail to respond to the crisis quickly and revealed blemishes in our public health system”. During this time, local hospital budgets around the U.S. were decreased significantly. People had to be turned away because hospitals could only afford to examine patients with the worst health issues. Societal attitudes during this time were very angry.

Examples of Medical Malpractice Cases of medical malpractices have raised their ugly head quite often in last few years. We are all aware of the common malpractice cases. Birth injuries, pregnancy issues, mental health, paralysis due to wrong medications are few cases that have occurred repeatedly over a long period of time. However, malpractice cases have broken these barriers and caused harm to patients suffering from other commonly unknown diseases or disorders. We thought of listing some lesser known examples of medical malpractices and hence have come up with some examples that will broaden your perspective about the gravity of the incident.

Insurance scams and contractor fraud made many people weary and distrustful regarding the rebuilding efforts and is one of many contributing factors to why many former residents have not returned to New Orleans. These are just some of the problems the City of New Orleans was faced with. A flood protection plan system designed by ACE (Army Corps of Engineers) that can endure a storm that could transpire once every 100

Introduction The trade of human organs in order to transplant is illegal in most countries. The increasing demand for organs and increasing rate of trade show the importance of this issue in today’s world. According to WHO, 91 countries conduct organ transplantation and every 10th organ transplanted are illegal (World Health Organization 2010). Kidney and Urology foundation of America found that in the US in early 2010 there were more than 121,678 individuals waiting for a new organ and for about 34000 individuals are added every year (Kidney & Urology Foundation of America 2016). In 1968, the United States executed the Uniform Anatomical Gift Act of 1968, which gave people the privilege to give their organs after their demise.

Cues to Action: These are signals that prompt one to take the initiative to treat illness. These can range from being exposed to health reports and messages in the mass media to watching a friend or relative suffer from the disease, reading a health pamphlet or even the onset of symptoms in one’s body. The model therefore says that an individual is more likely to seek treatment if he thinks he is prone to a disease that has severe consequences. For the individual to make the decision, though, his evaluation of whether the benefits of taking up treatment will outweigh the difficulties he will face in the process is crucial. In addition to the six factors that influence the making of a health care decision, various demographic factors like age, sex, race, social class, education, employment status, knowledge and experience play a role in how a person perceives the urgency of taking proper action to deal with his health condition.

Conversely, the destruction of families due to the volatile temperament induced by recreational drugs would have a lasting effect – a value of ‘-200 hedons’ would be plausible. In this instance the net worth of drug abuse would be ‘-195’ or ‘195 dolors’. In pursuit of “the greatest good for the greatest number”, the snowball effects must be considered. For example, the poor hygiene associated with intravenous drugs increases the spread of blood contagions, causing illnesses such as HIV in thousands of people thereby endangering their lives. In doing this, healthcare systems are monopolised, diverting taxpayer money away from treating unpreventable diseases.

PART I PRELIMINARY 1.1 Background If you see a news show on television, the most frequent topic dibicarkan is a corruption or fraud committed by individuals, non-profit organizations, corporations, and Government. By 2016, there is news that Safely Commission Corruption suspect the flow of funding from pharmaceuticals to doctors. The presence of invetigasi from Tempo magazine alleged gratuities increasingly strengthen doctors from pharmaceutical companies that menginkan products a cure was made a prescription for the patient's doctor. The Crime is one type of healthcare fraud relative seldom heard in Indonesia. Health Care Fraud is done doctors, medical personnel, health equipment suppliers, healthcare providers, to insurance companies.

INTRODUCTION The diagnosis and treatment of diseases pertaining to human beings is a very risky profession as it is accompanied by a high degree of morbidity and mortality. Since the profession is risky therefore the professionals should be more cautious while practicing medicine. Even the mere mistakes and recklessness can cause severe injuries that to an extent which possibly can take anyone’s lives. It means if a good treatment can save the life of a person the negligent one can take the very same. In early day’s medical science used to be a kind of a miracle for a layman.

Technology is as much of a friend as it is an enemy. On the one hand improved technology and electronic health records can help save lives by identifying allergies sooner but, one the other hand if the medical records are compromised by unwanted eyes of a neighbor or worst hacker privacy for the individuals are gone forever. Another hurdle facing the nationalized health system in this litigious society in which we live are employer funded insurance policies. Companies that are religious or have religious interest are contesting parts of the Affordable Care Act. For example, Hobby Lobby sued the government so that they “would not have to provide coverage for contraceptives for its employees” under the Religious Freedom Restoration Act (Strine, 2015, p. 91).

HIPAA Violation rocks hospital! An employee at St. Charles Health system accessed over 2400 patients’ medical records over a two-year period because they were curious. We all know that curiosity killed the cat and now it may have direr consequences for this curiosity seeker and the hospital system. HIPAA Violation without intent to commit fraud The employee who viewed the protected health information (PHI) without a legitimate reason to do so is in jeopardy of large civil fines, loss of their respective clinical license and criminal prosecution. Not to mention termination from their present position.

As a result, many hospitals fail to achieve a vaccination rate high enough to prevent the spread of the influenza virus. A recent article states that "only 42% of [health care workers] received the seasonal influenza vaccination during the 2005-06 influenza season" (Maroyka and Andrawis). Lower vaccination rates undoubtedly result in higher numbers of hospital-acquired influenza. In order for a hospital to reach an optimal rate of vaccination, yearly mandatory influenza vaccinations must be required, and the consequences for refusing the vaccine must be severe enough to motivate health care workers to receive

According to Thomas Allen Coburn, a senator, and medical doctor, reports that “Over the past decade, more than 1,000 veterans may have died as a result of VA malfeasance.” (Devine) That is a worriment, and the problem lies within management and lack of liability. CNN reported that clerks and administrators had made “secret waiting lists” to camouflage the long waiting times on the VA’s wait-list system. (Issitt) The Office of Inspector General reported “a systemic lack of integrity within some Veterans Health Administration facilities.”(Issitt) The scandal caused the deaths of the people that the program was there to protect. The mismanagement was not only in the waiting lists but also with the money. Four VA construction projects in Las Vegas, Orlando, Denver, and New Orleans an extra cost of $1.5 billion because poor scheduling and unnecessary luxuries.

If the E/M coding was done incorrectly the person would get in trouble for fraud, and not only that the office would have a bad reputation, and other insurance companies wouldn 't probably want to go through that office anymore. It is important that the E/M codes are done correctly, because if not it could cause a lot of trouble. RE: UNIT7 8/6/2015 1:16:10 PM I agree, E/M coding is the process of which physician and patient encounters.