The Congress Has Done To End Fraud In The Healthcare Setting Since 1980 (Essay Sample)

Fraud and Abuse in Health Care Setting
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Fraud and Abuse in Health Care Setting
Abuse and Fraud are on the rise, especially in the Healthcare platform. There is a need for healthcare systems to develop firm laws for addressing, detection and prevention of fraud and drug abuse. According to the Centre for Medicare and Medicaid Service (CMS), abuse in the healthcare is as a result of pointless investment directly or indirectly (Sattler, 2017). However, fraud in healthcare is a type of white-collar crime that entails filling misleading information to make a fortune. Fraud is a criminal offense hence culprits can face fines, incarceration and sometimes losing the right to practice healthcare practices in both public and private sector (Sattler, 2017).
Due to the predominance of such issues in the healthcare, there has been the establishment of laws and regulations like anti-Kickback Statute (AKS), False Claims Act (FCA), United States Criminal Code, and Physician Self-referral Law. The aim of these laws to provide administrative and criminal solutions that the government may subject to personals or groups that commit fraud or abuse of Medicare programs. Also, there are four meaningful solutions for eliminating these Medicare problems which include the application of computer-aided coding (CAC), implementation of data mining and data modeling, increasing the federal enforcement on abuse and fraud, and training healthcare staff on methods of detection of embezzled funds in a health institution (Sullivan, 2017).
The federal government developed a False Claim Act (FCA) in 1986 with the aim of targeting the rise in fraud in a healthcare setting. The act, also known as (Lincoln Law) imposes penalties on a person or group of contractors engaging in healthcare fraud (Sullivan, 2017). The suffering of professional damage and severe damages has led to the reduction of fraud for the past 30 years. Also, the safe labor and the Anti-Kickback statute prohibit any healthcare staff from receiving, ...