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29 cze 2020 · Prevention of Medicare and Medicaid fraud can be accomplished through several strategies at policy, practice, and grassroots levels. Efforts to curb this fraud at the policy level can be especially useful in combating identity theft and drug diversion.
Recommended strategies to combat fraud are discussed at policy, practice, and grassroots levels. Health care practitioners, including pharmacists, can use these strategies to protect themselves and their patients from becoming victims of fraud or unknowingly committing fraud.
10 wrz 2024 · Using case studies featuring Medicare claims data and HFPP Partner insights, this HFPP white paper provides a recommended approach to measuring the value of anti-fraud initiatives, demonstrates the importance of including deterrence in ROI calculations, and outlines strategies for doing so.
13 lis 2017 · The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best...
1 paź 2021 · Medicare fraud has been the cause of up to $60 billion in overpaid claims in 2015 alone. Upcoding occurs when a healthcare provider has submitted codes for more severe conditions than diagnosed for the patient to receive higher reimbursement.
Fraud and abuse perpetrators disproportionately treat minority, disabled, and low-income Medicare beneficiaries, which may contribute to health outcome disparities; however, to our knowledge, no previous study has investigated the possibility of an association between exposure to FAPs and health care outcomes. 11 In this study, we estimated the ...
Medicare and other Federal health care programs rely on physicians’ medical judgment to treat patients with appropriate, medically necessary services, and to submit accurate claims for Medicare-covered health care items and services.
