U.S. healthcare is a $2.5 trillion system that represents more than 17 percent of the country’s GDP. It is likewise extremely vulnerable to scams. Price 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’s Medicaid scams workplace recuperated $283 million and acquired 148 criminal convictions. In July 2010, the U.S. Justice Department charged almost 100 clients, physicians, 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 offered.
These cases just mean the scope of the issue. In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap handles medical scams and its financial, mental, and social expenses.
Illustrated throughout with lots of particular and frequently interesting cases, this book covers a wide array of criminal offenses: kickbacks, illegal recommendations, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill plans, insurance coverage frauds, short-pilling, off-label marketing of pharmaceuticals, and refund scams, in addition to criminal acts that allow this scams (mail and wire scams, conspiracy, and cash laundering).
After evaluating the efficiency of the federal laws created to eliminate 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 suppliers, customers, insurance providers, and federal and state authorities can bring healthcare scams and abuse under control, therefore decreasing the total expense of healthcare in America.
http://medicalbillingcertificationprograms.org/phantom-billing-fake-prescriptions-and-the-high-cost-of-medicine-health-care-fraud-and-what-to-do-about-it/
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