Question

Considers aspects of Medicare fraud and abuse. Discuss the nature, scope, and financial impact of the issue on health care organizations. Do you think that efforts to curtail fraud and abuse have been successful? What, if anything, should be done differently to further decrease, and also discourage, fraud and abuse?

Answer 1

Nowadays fraud and abuse increasing in diffrent ways, the common types we found are duplicate billing,and billing for services not even performed.Over treatment,converting of non-covered services in to a covered sevice.Billing for unnecessary medical tests or tests never performed.the scope of this action are insurance companies and hospitals.financial expenditure will increase and it makes burdon for govt,and patient.

I think fraud and abuse can be reduce by strict regulations and acts and tight implimentations of it,but practically not easy.we can limit this to a certain level.

for further decrease, and also discourage, should audit frequently and if found any malpractices should take actions against it legally as penalties or canceling of licene,imprisonement etc.