U.S. healthcare is a $2.5 trillion system that represents more than 17 percent of the country’s GDP. It is likewise extremely prone to scams. Quotes differ, however some observers think that as much as 10 percent of all medical billing includes some kind of scams.
In 2009, New york city’s Medicaid scams workplace recuperated $283 million and gotten 148 criminal convictions. In July 2010, the U.S. Justice Department charged almost 100 clients, medical professionals, and healthcare executives in 5 states of bilking the Medicare system out of more than $251 million through incorrect claims for services that were clinically unneeded or never ever supplied.
These cases just mean the scope of the issue. In Phantom Billing, Phony Prescriptions, and the High Expense of Medication, Terry L. Leap handles medical scams and its financial, mental, and social expenses.
Illustrated throughout with lots of particular and typically interesting cases, this book covers a variety of criminal activities: kickbacks, illegal recommendations, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill plans, insurance coverage rip-offs, short-pilling, off-label marketing of pharmaceuticals, and refund scams, along with criminal acts that allow this scams (mail and wire scams, conspiracy, and cash laundering).
After examining the efficiency of the federal laws developed to combat healthcare scams and abuse– the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws– Leap recommends a variety of manner ins which healthcare companies, customers, insurance providers, and federal and state authorities can bring healthcare scams and abuse under control, thus decreasing the total expense of healthcare in America.
http://medicalbillingcertificationprograms.org/phantom-billing-phony-prescriptions-and-the-high-expense-of-medication-healthcare-scams-and-what-to-do-about-it/
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