Page 1 of 2 Caterra Bruno05/17/2018HS115A medical assistant was sentenced today to 36 months in prison for his role in a conspiracy to defraud the Medicare program, the Departments of Justice and Health and Human Services announced. Guy Ross was also sentenced by U.S. District Judge Denise Page Hood in the Eastern District of Michigan to three years of supervised release following his prison term and was ordered to pay $472,623 in restitution. Ross, 51, pleaded guilty in July 2010 to one count of conspiracy to commit health care fraud. According to court documents, Ross received kickbacks from the owners and/or operators of two Detroit-area home health agencies, Patient Choice Home Healthcare Inc. and All American Home Care Inc., in exchange
There are some many ways if Identity theft. There is when someone uses a person name, social security number. Medical Identity theft can come from a Friend, family, and acquaintances. Even by strangers, who can steal someone 's Identity who can obtain medical care, service, or equipment. They don 't have medical care.
Since HIPAA become mandatory on most of the health care organization, patient information is more secure compared to previous. Health care organization are investing huge amount of fund for safety measures to protect the patient information and i think this is the main concern in today's advanced health care
Fraud is all around us. Especially in the health care industry. What is being done to prevent fraud from reoccurring over and over in the health care industry? In the article “New medical codes can better catch fraud, but training is needed” by Tami Rockholt, RN, BSN; Mike Fossey; Mary McLean, BS discuses the topic of health care organizations transferring from ICD-9 to ICD-10 to help decrease fraud in the coding and billing department.
Annotated Bibliography: Medicare Fraud and Abuse Carolann Stanek University of Mary Annotated Bibliography: DiSantostefano, J. (2013). Medicare Fraud and Abuse Issues. Journal for Nurse Practitioners, 9(1), 61-63. doi:10.1016/j.nurpra.2012.11.014
There was improvement in many areas of the country following the crackdown on prescription drug abuse and pill mills. However, another result of the crackdownwas a diminution in the availability of prescription painkillers and the price for the painkillers on the street became more expensive. The ones who became addicted to painkillers during the pill mill epidemic then turned to heroin. The crackdown of pill mills inadvertently fueled the epidemic of heroin. “Between 2007 and 2012, heroin use rose 79 percent nationwide, according to federal data.
Every organization is at risk for breach, but the difference between entities will be reflected in how they implement policies, procedures and corrective actions. For example, changes to the HIPAA rules regarding the accounting of health information disclosures expected this year have the potential to dramatically expand HIM and release of information (ROI) responsibilities and pose operational challenges. Every step within the release of information should be addressed through training, with these particular areas: front desk personnel, document identification and the pre-shipment validation. Finally, just prior to submission to the requester, release of information staff should always validate that only the uniquely authorized information has been included an that the information imported into the release of information process for disclosure belongs exclusively to that patient. If this is the case, the the release of information staff must implement and perform quality control measures to validate that another patient's information was not inadvertently imaged or indexed to the original patient's
Confidentiality and data breaches are a few of the main concerns, as many providers become neglectful when sharing patient electronic health information. Current use of Electronic Health Records (EHR) has proven to be helpful for hospitals and independent medical practice to provide efficient care for patients. Balestra reports that using computers to maintain patient health records and care reduces errors, and advances in health information technology are saving lives and reducing cost (Balestra, 2017). As technology advances EHR are going to continue to be the main method of record keeping among medical providers. Therefore, staff and medical providers need to be trained on how to properly share patients EHR safely and in a secure form in order to maintain patient confidentiality.
You should also make it a point to never discuss any patient information within ear shot of another person or patient. If a patient is in need of a copy of their personal records, take all the necessary steps
This is called protected health information or PHI. Information meets the definition of PHI if, even without the patient’s name, if you look at certain information and you can tell who the person is then it is PHI. The PHI can relate to past, present or future physical or mental health of the individual. PHI describes a disease, diagnosis, procedure, prognosis, or condition of the individual and can exist in any medium files, voice mail, email, fax, or verbal communications. defines information as protected health information if it contains the following information about the patient, the patient’s household members, or the patient’s employers, Names, Dates relating to a patient, i.e. birth dates, dates of medical treatment, admission and discharge dates, and dates of death, Telephone numbers, addresses (including city, county, or zip code) fax numbers and other contact information, Social Security numbers, Medical records numbers, Photographs, Finger and voice prints, Any other unique identifying
Healthcare ethics involves making well researched and considerate decisions about medical treatments, while taking into consideration a patient's beliefs and wishes regarding all aspects of their health. The healthcare industry has regard for the issues surrounding the welfare of their patients. Doctors, nurses, and other professionals who have the ability to affect a patient's health are all forced to make ethical decisions on a daily basis. I believe the result of ability to pay versus quality of care comes into ethical question in today’s society.
I think it’s wrong for the government to penalize physicians for not meeting compliance standards. However, It’s a great opportunity for the government to aim at small practices because this is where physicians are self-employed. These types of physicians have numerous clinic or health care facilities and are most likely to commit fraud. This seems kind of biased, but it’s true. According to, Ornstein, the most common sanctions are against physicians who have odd Medicare billing reputations (2014, title).
Medicare fraud is a very common occurrence in the United States. However, there are whistleblowers who are working hard to stop Medicare fraud. The vast majority of people who report Medicare fraud are healthcare professionals. This includes people such as ambulance drivers, physicians, nursing home workers, hospice workers and nurses. There have been some changes recently to the United States whistleblower laws.
The History, Incidence, Costs and Institutional Remedies Medicare fraud and abuse is a serious problem. While the majority of healthcare providers appear to be honest and well-intentioned, there is still a marginal amount of provider’s intent on abusing the system. This sort of abuse is detrimental, not only does it cost taxpayers billions of dollars but it put the beneficiaries’ health and welfare at risk and puts an increased strain on Federal and state budgets. The effect is then realized and the risks are magnified by the growing number of people served by Medicare. Thus the need for prevention, in this paper we will discuss the history, incidence, costs and institutional remedies that where taken in previous incidences of Medicare fraud
Medical Malpractice Everyone makes mistakes, but some are more deadly than others. Malpractice is the illegal or negligence, professional activity or they’re working out of the their scope of practice. Medical malpractice is one of the top causes of death in the United States. With this being said, insurance for medical practitioners would be considerably higher.
