Fraud in Medicare Facilities
Q.1
Medicare is an easy mark for fraudulent equipment sales because people have failed to account for the authenticity of suppliers of the equipment (Blanchard 2015). No check is done on the genuineness of the patients’ conditions as well as checking how qualified the doctors are.
Ghost services are services offered by people who have no enough knowledge about what they are doing. It’s mostly done by greedy people who want to access money easily without meeting the right and the required requirements.
US healthcare system is vulnerable to fraud, waste, and abuse because of inadequate funding by the government, which leads to a lack of legal and administrative tools to available to the federal government. The presence of fee for service payment systems in the private sector and automated claims processing systems.
Q.2
Different forms of excessive medical billing. Excessive services which are billing something more significant than what level of genuine care requires. This can apply for both services or items. Duplicated claims where the provider changes some portions to charge twice for the same service given. Upcoded services which overcharging a patient instead of charging them for the actual procedure they underwent. Unnecessary services which include claims that are filed for care that in no way applies to the patient. Like antibiotics billed for a patient with cancer disease. Billing for services not offered, which can either be through the use of bribes to corrupt medical officers or forge signatures of those working in those institutions (McKnight 2014). Upcoded items which involve overcharging a patient for giving them a different thing and not what they deserve. Like providing fake types of equipment. Criticisms by HMO’s include methodology used to support cross country health systems that may continue to be an easy and straight forward way to promote fraud and abuse in the medical sector. Lack of a reliable database with uniform definitions of health inputs and outputs. Lack of limited resources to provide services at an acceptable level of quality by the health service planners.
Q.3
The initial casualty of the first law of electronic crime was John Edward Robinson. Phone phreaks were those people who loved hacking or exploring the telephone system and experimenting with it to understand how it works. This was John Draper and Captain Crunch. The blue box was used to generate the in-band signaling audio tones used to control long-distance telephone exchanges. Electronic computer crime should be discouraged because it exposes one’s confidential information, and it may as well threaten nations’ security and financial health (Fehr et al. 2016).
Q.4
Americans have changed their expectations regarding wealth; they are no longer conformists interested in jobs and economic security. They have focused on investments and business, which will provide direct income to them, and it limits unemployment jobs and risks of losing of a career in case you were employed (Obama 2016). Self-employment basically provides job security to the individuals. Education is no longer a guarantee for a successful and fulfilling career. With or without a degree, you suffer consequences of unemployment due to a high population and high numbers of qualified citizens (Lazear 2013). Huge bonuses provided to executives were not justified because these should be used to promote youths running their own business to help them grow instead. Executives have already established themselves, and therefore they do not deserve such bonuses.