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Medicaid ensures that proper healthcare is provided to any person who cannot afford to pay their health bill. This can be done by paying for the entire bill or contributing to it. By catering to the needs of the lower income groups, it pays the bills directly to the hospital instead of rallying them through the individual himself…
This act aims at punishing all those who: give false certifications or false information, pretend to be in need of medical necessity or self referrals which allow a physician to gain money through referring a patient to a facility in which he has a monetary interest. All matters like these are presented to the False Claims Act who intervenes through several ways: acting as a plaintiff, allowing the realtor to prosecute on behalf of the US government or dismissing the complaint if it is against government policy. An instance like this date back to 1998 when the Assistant Secretary of Legislation was asked to review the healthcare department as incorrect billing had led to a loss of $6 billion. (Morris) Instances like these can also be presented and placed under the False Claims Act.
In 2005 the dramatic deficits made by the government forced the Deficit Reduction Act to allow the Congress to decide that the Centers of Medicaid and its services(CMS) were to establish the Medicaid Integrity Plan. This plan was created to suit two purposes: to use contractors who would identify overpayments and audit claims and to provide support to combat fraud and abuse (HHS.gov). The most efficient manner for eradicating frauds is to deploy precautionary measures to avoid even its initiation. ...
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