Question

Healthcare Fraud is a dishonest act committed by a healthcare professional in order to receive additional compensation for medical services. Healthcare fraud comes in many forms, such as unbundling, upcoding, billing for services that never happened, or falsifying documents. Once discovered, the fraudulent person is quickly arrested, but their actions negatively affects the reputation and brand of the healthcare organization.

During this activity, you will be writing a 2-3 page paper. To start with, you must review the link below and find a "real life" healthcare fraud case. After locating a case, please research the organization that was affected by the situation. Next, please create a SWOT analysis, which you will describe in paragraph form in your paper, which identifies challenges and opportunities that the organization will face while rebuilding their image.

Link:
https://oig.hhs.gov/fraud/enforcement/criminal/

Answer 1

Real life health care fraud case:
Walgreen boots Alliance has settled two fraud case with the department of justice..Manhatten U.S Attorney announces $269.2 million recovery..
The first settlement of $209.2 million resolves allgation that the company improperly billed medicare,medicaid and other federal health care programs for hundred of thousand of insulin pens it dispensed ,which beneficiaries who actually did not need them..so federal health care programs paid walgreens millions of dollars for insulin that patient did not need that,more quantities of valuable medication was wasted..
Now walgreens pays $160million to the united states and $ 41.2million to state government..Walgreen practices undermined the integrity of the medicare and medicaid programs,compromised patient care and wasted tax payer dollars.
law enforcement partners,HHS-OIG will continue to protect the person that depend on federal fund health care programs..$60 million to overcharged government health care plans for prescription drugs..The settlement against retail pharmacy under False claims Act..
SWOT analysis organised with strengths,weakness,oppurtunities and threats.
Strengths: It describes organization positive attributes, and how well organization run with resources and other departments..extra knowledge and skills which improves patient satisfaction and quality of care..knowledge and skills including competition, development capacity,positive aspects etc..
Weaknesses: In where the organization looses its strengths and values, competitive disadvantages..The organization should find out the area where it loose the values ..in which area it has to get improve to accomplish the objectives for become a strong competitor.find the limited resources and poor location,access to skills and technologies..
Oppurtunities: Find oppurtunites to improve market level which we can get benefits,analyse how the business level at present..strategy to be followed which improve the quality and standards of the organization..
Threats: External factors beyond our control that make the organization at risk.. Findout the factors and barriers make plan to face the situation..Find the challenges unfavorable trend which decrease the profits and revenues..