Since the industrial revolution man has developed and invented numerous things that have helped them in different areas of life. These inventions and technological advancements have become a necessity of life now in the present. One of such advancements has been achieved in medical science…
Medical Science is still in its development stages as cures for diseases that were incurable are being developed. Such an example is of cancer, Hepatitis B and etc. These diseases were incurable some time ago but the advancement in medical sciences has enabled doctors to cure such diseases. Treatment for these diseases is not only available but is also done at cheap rates that are affordable, but still affordability has been a problem. Medical Science has experienced two major problems in the last decade. Number one is the affordability of treatment and medicines for people and secondly the fraud and abuse of medicines which has become very common around the world (Kelman & Straker, 1999). In this paper we will discuss how the federal government of US has controlled the cost associated with the Medicaid program and how it has helped reduce the Medicaid fraud and abuse.
Good health is significant to everyone. If a person can't pay for medical care right now, Medicaid can make it probable for him or her to get the care that is needed so that the person can get healthy and stay fit. Medicaid is obtainable only to certain low-income individuals and families who fit into an eligibility cluster that is recognized by federal and state law. Medicaid does not disburse money to a person instead, it sends payments straight to the person's health care provider (Heiser, 2008). Depending on the state's rules, a person may also be asked to compensate a small division of the charge for a few medical services. Medicaid is a state administered plan and each state sets its individual guidelines regarding eligibility and services. Many groups of people are roofed by Medicaid, even within these groups, though, definite requirements must be met. These may comprise of age, pregnancy, disability, blindness, or old age, income and resources and if a person is a U.S. citizen or a lawfully admitted immigrant. The regulations for counting the income and resources differ from state to state and from group to group. There are particular rules for those who reside in nursing homes and for disabled children living at home (Commerce Clearing House, 2007). A child may be entitled for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if his or her parents are not. Eligibility for children is based on the child's status, not the parent's. Also, if someone else's child lives with a person, the child may be qualified even if that person is not because the earnings and resources will not add up for the child.
Fraud and Abuse
The Centers for Medicare & Medicaid Services CMS is dedicated to fighting fraud and abuse, which redirect dollars that could or else be spent to preserve the health and welfare of Medicaid customers. To fortify its obligation, CMS has implemented a Medicaid veracity module. This is in reply to the requirements of the Deficit Reduction Act DRA of 2005, finalized on February 8, 2006 by the President, in which Congress proposed CMS to establish the Medicaid Integrity Program MIP. In doing so, it spectacularly augmented the resources accessible to CMS to fight fraud, misuse and exploitation in the Medicaid program. The DRA says that a five-year Comprehensive Medicaid Integrity Plan CMIP be printed to guide MIP growth and functions. This CMIP specially discusses statutory necessities, program ...
Cite this document
(“Medicaid Health Care Finance Essay Example | Topics and Well Written Essays - 750 words”, n.d.)
Retrieved from https://studentshare.net/miscellaneous/301253-medicaid-health-care-finance
(Medicaid Health Care Finance Essay Example | Topics and Well Written Essays - 750 Words)
“Medicaid Health Care Finance Essay Example | Topics and Well Written Essays - 750 Words”, n.d. https://studentshare.net/miscellaneous/301253-medicaid-health-care-finance.
Running head: SELF REFLECTIVE ESSAY Self Reflective Essay Student’s First name, Middle initial and Last name Name of University BHS427 Health Care Finance June 20, 2011 I have always been very interested in learning about the various aspects of health care management.
Most importantly, aid is given to American citizens or the lawfully admitted immigrant.
Medicaid fraud is generally committed by individuals seeking to collect healthcare reimbursements under false pretences. At instances like these Medicaid services render the help of the False Claims Act.
Various states maintain this Medicaid program but add their own rules and benefits to make it more specific. This essay will discuss the differences and similarities between two such American states: Texas and Oklahoma.
The eligibility of aid for children under 18 in both states varies at one vital mode.
Medicaid is a program that is administered by a federal-state partnership, jointly financed and regulated by the states under federal guidelines. This has placed many states in a budget crisis as an ever increasing portion of new tax dollars are spent to finance the program.
Some states have been more proactive than others through the state administered Medicaid programs at monitoring expenses and containing health care costs. Two of the country's largest states, New York and Texas, have similar demographics, yet vary significantly in the amount spent and the Medicaid program structure.
rm care assisted living facilities, and two home healthcare agencies; Fullhealth was able to maximize its existing resources in terms of increasing the number of its Medicaid, Medicare and employer sponsored health plan enrolees.
The role of third party payers plays a
HCRA also combined the hospital rates reimbursed by employees’ compensation and free coverage with the Medicaid segment rates. The previous act, the “New York Prospective Hospital Reimbursement Methodology” (NYPHRM), resembles the
One of the most essential elements to understand in North Carolina Health Care Coverage is the fact that each program is customized for individuals with different needs. For instance, pregnant women have a special package of benefits all