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Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging in fraud are always seeking new ways to circumvent the law. Damages from fraud can be recovered by use of the False Claims Act, most commonly under the ''qui tam'' provisions which rewards an individual for being a "whistleblower", or relator (law). Recent news and statistics The FBI estimates that ''Health Care Fraud'' costs American tax payers $80 billion a year. Of this amount $2.5 billion was recovered through ''False Claims Act'' cases in FY 2010. Most of these cases were filed under ''qui tam'' provisions. Over the course of FY 2010, ''whistleblowers'' were paid a total of $307,620,401.00 for their part in bringing the cases forward. F ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
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] |
Snake Oil
Snake oil is a term used to describe False advertising, deceptive marketing, health care fraud, or a scam. Similarly, snake oil salesman is a common label used to describe someone who sells, promotes, or is a general proponent of some valueless or fraudulent cure, remedy, or solution. The term comes from the "snake oil" that used to be sold as a cure-all elixir for many kinds of physiological problems. Many 18th-century European and 19th-century United States entrepreneurs advertised and sold mineral oil (often mixed with various Active ingredient, active and Inactive ingredient, inactive household herbs, spices, drugs, and compounds, but containing no snake-derived substances whatsoever) as "snake oil liniment", making claims about its efficacy as a Panacea (medicine), panacea. Patent medicines that claimed to be panaceas were extremely common from the 18th century until the 20th century, particularly among vendors masking addictive drugs such as cocaine, amphetamine, Alcohol (d ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Tricare
Tricare (styled TRICARE) is a health care program of the United States Department of Defense The United States Department of Defense (DoD, USDOD, or DOD) is an United States federal executive departments, executive department of the federal government of the United States, U.S. federal government charged with coordinating and superv ... Military Health System. Tricare provides civilian Health benefits (insurance), health benefits for Uniformed Services of the United States, U.S Armed Forces military personnel, military retirees, and their Dependent (law), dependents, including some members of the Reserve component of the Armed Forces of the United States, Reserve Component. Tricare is the civilian care component of the Military Health System, although historically it also included health care delivered in military medical treatment facilities. The Tricare program is managed by the Defense Health Agency. Before 1 October 2013, it was managed by the Tricare Management Ac ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fraud
In law, fraud is intent (law), intentional deception to deprive a victim of a legal right or to gain from a victim unlawfully or unfairly. Fraud can violate Civil law (common law), civil law (e.g., a fraud victim may sue the fraud perpetrator to avoid the fraud or recover monetary compensation) or criminal law (e.g., a fraud perpetrator may be prosecuted and imprisoned by governmental authorities), or it may cause no loss of money, property, or legal right but still be an element of another civil or criminal wrong. The purpose of fraud may be monetary gain or other benefits, such as obtaining a passport, travel document, or driver's licence. In cases of mortgage fraud, the perpetrator may attempt to qualify for a mortgage by way of false statements. Terminology Fraud can be defined as either a civil wrong or a criminal act. For civil fraud, a government agency or person or entity harmed by fraud may bring litigation to stop the fraud, seek monetary damages, or both. For cr ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Quackery
Quackery, often synonymous with health fraud, is the promotion of fraudulent or Ignorance, ignorant medicine, medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials they do not possess; a charlatan or snake oil salesman". The term ''quack'' is a Clipping (morphology), clipped form of the archaic term ', derived from a "hawker of salve" or rather somebody who boasted about their salves, more commonly known as ointments. In the Middle Ages the term ''quack'' meant "shouting". The quacksalvers sold their wares at markets by shouting to gain attention. Common elements of general quackery include List of diagnoses characterized as pseudoscience, questionable diagnoses using List of questionable diagnostic tests, questionable diagnostic tests, as well as untested or refuted treatments, especially for serious diseases such as alternative cancer trea ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Benefit Fraud
Benefit(s) may refer to: Arts and entertainment * ''Benefit'' (album), by Jethro Tull, 1970 * "Benefits" (''How I Met Your Mother''), a 2009 TV episode * "Benefits", a 2018 song by Zior Park * '' The Benefit'', a 2012 Egyptian action film Businesses and organisations * Benefit Cosmetics, an American cosmetics company * The Benefit Company, a Bahraini interbanking company Places * Benefit, Georgia, US Welfare and employment * Benefit (social welfare) ** Federal benefits, US ** Unemployment benefits * Benefit (sports), a pre-retirement event to benefit a player * Benefit performance, entertainment to support a cause ** Benefit concert, or charity concert * Employee benefits ** Health benefits (insurance) See also * Entitlement (other) * Health benefits (medicine) * Incentive In general, incentives are anything that persuade a person or organization to alter their behavior to produce the desired outcome. The laws of economists and of behavior state that ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
The Washington Post
''The Washington Post'', locally known as ''The'' ''Post'' and, informally, ''WaPo'' or ''WP'', is an American daily newspaper published in Washington, D.C., the national capital. It is the most widely circulated newspaper in the Washington metropolitan area and has a national audience. As of 2023, the ''Post'' had 130,000 print subscribers and 2.5 million digital subscribers, both of which were the List of newspapers in the United States, third-largest among U.S. newspapers after ''The New York Times'' and ''The Wall Street Journal''. The ''Post'' was founded in 1877. In its early years, it went through several owners and struggled both financially and editorially. In 1933, financier Eugene Meyer (financier), Eugene Meyer purchased it out of bankruptcy and revived its health and reputation; this work was continued by his successors Katharine Graham, Katharine and Phil Graham, Meyer's daughter and son-in-law, respectively, who bought out several rival publications. The ''Post ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Kickbacks
A kickback is a form of negotiated bribery in which a commission is paid to the bribe-taker in exchange for services rendered. Generally speaking, the remuneration (money, goods, or services handed over) is negotiated ahead of time. The kickback varies from other kinds of bribes in that there is implied collusion between agents of the two parties, rather than one party extorting the bribe from the other.Wrage, Alexandra Addison. ''Bribery and Extortion: Undermining Business, Governments, and Security.'' Westport, Conn.: Praeger Security International, 2007. p. 14. The purpose of the kickback is usually to encourage the other party to cooperate in the scheme.Kranacher, Riley, and Wells, p. 387. The term "kickback" comes from colloquial English language, and describes the way a recipient of illegal gain "kicks back" a portion of it to another person for that person's assistance in obtaining it.Campos, p. 299. Types and methods The most common form of kickback involves a vendor subm ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Wheelchair
A wheelchair is a mobilized form of chair using two or more wheels, a footrest, and an armrest usually cushioned. It is used when walking is difficult or impossible to do due to illnesses, injury, disabilities, or age-related health conditions. Wheelchairs provide mobility, postural support, and freedom to those who cannot walk or have difficulty walking, enabling them to move around, participate in everyday activities, and live life on their own terms. Wheelchairs come in a wide variety of formats to meet the specific needs of their users. They may include specialized seating adaptions, and individualized controls, and may be specific to particular activities, as with sports wheelchairs and beach wheelchairs. The most widely recognized distinction is between motorized wheelchairs, where propulsion is provided by batteries and electric motors, and manual wheelchairs, where the propulsive force is provided either by the wheelchair user or occupant pushing the wheelchair by ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Kickbacks
A kickback is a form of negotiated bribery in which a commission is paid to the bribe-taker in exchange for services rendered. Generally speaking, the remuneration (money, goods, or services handed over) is negotiated ahead of time. The kickback varies from other kinds of bribes in that there is implied collusion between agents of the two parties, rather than one party extorting the bribe from the other.Wrage, Alexandra Addison. ''Bribery and Extortion: Undermining Business, Governments, and Security.'' Westport, Conn.: Praeger Security International, 2007. p. 14. The purpose of the kickback is usually to encourage the other party to cooperate in the scheme.Kranacher, Riley, and Wells, p. 387. The term "kickback" comes from colloquial English language, and describes the way a recipient of illegal gain "kicks back" a portion of it to another person for that person's assistance in obtaining it.Campos, p. 299. Types and methods The most common form of kickback involves a vendor subm ... [...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] |
