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Medicare Fraud
In the United States, Medicare fraud is the claiming of Medicare (United States), Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately. The total amount of Medicare fraud is difficult to track, because not all fraud is detected and not all suspicious claims turn out to be fraudulent. According to the Office of Management and Budget, Medicare "improper payments" were $47.9 billion in 2010, but some of these payments later turned out to be valid.politifact.com (2011-01-04). Retrieved on 2011-01-05. The Congressional Budget Office estimates that total Medicare spending was $528 billion in 2010. < ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicare (United States)
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with End Stage Renal Disease Program, end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It started in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS). Medicare is divided into four parts: A, B, C and D. Part A covers hospital, skilled nursing, and hospice services. Part B covers outpatient services. Part D covers self-administered prescription drugs. Part C is an alternative that allows patients to choose private plans with different benefit structures that provide the same services as Parts A and B, usually with additional benefits. In 2022, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people. According to annual Medicare ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Health Maintenance Organization
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis. The US Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status. Operation HMOs often require members to select a primary car ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicaid Fraud
Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program, although all have since 1982. Medicaid was established in 1965, part of the Great Society set of programs during President Lyndon B. Johnson’s Administration, and was significantly expanded by the Affordable Care Act (ACA), which was passed in 2010. In most states, any member of a household with income up to 138% of the federal poverty line qualifies for Medicaid coverage under the provisions of the ACA. A 2012 Supreme Court decision established that states may continue to use pre-ACA Medicaid eligibility s ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Adam B
Adam Beales (born 11 October 1999), known as Adam B, is a YouTuber, actor, and television host from Derry, Northern Ireland. He is a former co-presenter of the CBBC shows '' The Dog Ate My Homework'' and ''Blue Peter''. Beales has over 4 million subscribers on YouTube and has collaborated with Disney. Early life Beales was born on 11 October 1999 in Derry, Northern Ireland. He completed his schooling at St Columb's College, where he was Head Boy. Career At the age of 12, he started his channel Adam B (which was then called “TheNewAdamb99”) on 29 July 2012. He started by filming all of his videos and editing them from his bedroom in his parents' house. In 2017, he made a partnership with Disney. In 2019, his YouTube channel reached over 2.7 million subscribers with a total of 300 million views. He has appeared on BBC Radio, '' The Ryan Tubridy Show'' and was featured on VidCon London's first conference. In June 2019, he won the Youth 19 Champions Award. From 2019-20, h ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Risperdal
Risperidone, sold under the brand name Risperdal among others, is an atypical antipsychotic used to treat schizophrenia and bipolar disorder, as well as aggressive and self-injurious behaviors associated with autism spectrum disorder. It is taken either by mouth or by injection (i.e., subcutaneous or intramuscular). The injectable versions are long-acting and last for 2–4 weeks. Common side effects include weight gain, drowsiness, fatigue, insomnia, dry mouth, constipation, elevated prolactin levels, and restlessness. Serious side effects may include the potentially permanent movement disorder tardive dyskinesia, as well as neuroleptic malignant syndrome, an increased risk of suicide, and high blood sugar levels. In older people with psychosis as a result of dementia, it may increase the risk of death. It is unknown if it is safe for use in pregnancy. Its mechanism of action is not entirely clear, but is believed to be related to its action as a dopamine and serotonin a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Johnson & Johnson
Johnson & Johnson (J&J) is an American multinational pharmaceutical, biotechnology, and medical technologies corporation headquartered in New Brunswick, New Jersey, and publicly traded on the New York Stock Exchange. Its common stock is a component of the Dow Jones Industrial Average, and the company is ranked No. 42 on the 2024 ''Fortune'' 500 list of the largest United States corporations. In 2024, the company was ranked 45th in the ''Forbes'' Global 2000. Johnson & Johnson has a global workforce of approximately 138,000 employees who are led by the company's current chairman and chief executive officer, Joaquin Duato. Johnson & Johnson was founded in 1886 by three brothers, Robert Wood Johnson, James Wood Johnson, and Edward Mead Johnson, selling ready-to-use sterile surgical dressings. In 2023, the company split-off its consumer healthcare business segment into a new publicly traded company, Kenvue. The company is exclusively focused on developing and producing ph ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Nursing Homes
A nursing home is a facility for the residential care of older people, senior citizens, or disabled people. Nursing homes may also be referred to as care homes, skilled nursing facilities (SNF), or long-term care facilities. Often, these terms have slightly different meanings to indicate whether the institutions are public or private, and whether they provide mostly assisted living, or nursing care and emergency medical care. Nursing homes are used by people who do not need to be in a hospital, but require care that is hard to provide in a home setting. The nursing home staff attends to the patients' medical and other needs. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. In the United States, while nearly 1 in 10 residents aged 75 to 84 stays in a nursing home for five or more years, nearly 3 in 10 residents in that age group stay less than 100 days, the maximum duration covered by Medicare, according to the American Association for Long-Te ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Whistleblower
Whistleblowing (also whistle-blowing or whistle blowing) is the activity of a person, often an employee, revealing information about activity within a private or public organization that is deemed illegal, immoral, illicit, unsafe, unethical or fraudulent. Whistleblowers can use a variety of internal or external channels to communicate information or allegations. Over 83% of whistleblowers report internally to a supervisor, human resources, compliance, or a neutral third party within the company, hoping that the company will address and correct the issues. A whistleblower can also bring allegations to light by communicating with external entities, such as the media, government, or law enforcement. Some countries legislate as to what constitutes a protected disclosure, and the permissible methods of presenting a disclosure. Whistleblowing can occur in the private sector or the public sector. Whistleblowers often face retaliation for their disclosure, including termination of emp ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medicaid
Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by U.S. state, state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding. States are not required to participate in the program, although all have since 1982. Medicaid was established in 1965, part of the Great Society set of programs during Presidency of Lyndon B. Johnson, President Lyndon B. Johnson’s Administration, and was significantly expanded by the Affordable Care Act (ACA), which was passed in 2010. In most states, any member of a household with income up to 138% of the federal Poverty line in the United States#Measures of poverty, poverty line qualifies for Medicaid coverage under the provisions of the ACA. A 201 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hospital Corporation Of America
HCA Healthcare, Inc. (historically known as Hospital Corporation of America) is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,400 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 20 states and the United Kingdom. As of 2024, HCA Healthcare is ranked #61 on the Fortune 500 rankings of the largest United States corporations by total revenue. In the 1990s, the company engaged in illegal accounting and other crimes that resulted in the payment of more than $2 billion in federal fines and other penalties, and the dismissal of the CEO Rick Scott by the board of directors. History Early years The Hospital Corporation of America (HCA) was founded in 1968 in Nashville, Tennessee, by Thomas F. Frist Sr., Thomas F. Frist Jr. and Jack C. Massey. The founders envisioned a c ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Rick Scott
Richard Lynn Scott ( Myers; born December 1, 1952) is an American attorney, businessman, politician, and United States Navy, Navy veteran serving as the Seniority in the United States Senate, senior United States senator from the state of Florida, a seat he has held since 2019. A member of the Republican Party (United States), Republican Party, he served two terms as the 45th governor of Florida from 2011 to 2019. Scott is a graduate of the University of Missouri–Kansas City and the Dedman School of Law at Southern Methodist University. In 1987, after serving in the U.S. Navy and becoming a law firm partner, he co-founded Columbia Hospital Corporation. Columbia later merged with another corporation to form Columbia/HCA, which eventually became the nation's largest for-profit health care company. Scott was pressured to resign as chief executive of Columbia/HCA in 1997. During his tenure as chief executive, the company defrauded Medicare, Medicaid, and other federal programs ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Columbia/HCA
HCA Healthcare, Inc. (historically known as Hospital Corporation of America) is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owned and operated 186 hospitals and approximately 2,400 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 20 states and the United Kingdom. As of 2024, HCA Healthcare is ranked #61 on the Fortune 500 rankings of the largest United States corporations by total revenue. In the 1990s, the company engaged in illegal accounting and other crimes that resulted in the payment of more than $2 billion in federal fines and other penalties, and the dismissal of the CEO Rick Scott by the board of directors. History Early years The Hospital Corporation of America (HCA) was founded in 1968 in Nashville, Tennessee, by Thomas F. Frist Sr., Thomas F. Frist Jr. and Jack C. Massey. The founders envisioned ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
