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Medicare fraud has been all over the news and the federal government has been aggressively fighting this crime with much success According to Kaiser Health News nd within the last two years the government has revoked the ability of over 14000 providers to bill for services due to fraudulent billing practices As part of the Patient Protection and Affordable Care Act the government has established funds to implement fraud prevention procedures using state-of-the-art technology mirroring that of the credit card industry Parks 2012 The White House 2013 attributes close to 107 billion dollars in savings to these healthcare reform programs in a crime that many estimate costs the government 60 billion a year Mckee nd While these cost-saving achievements are significant one needs to keep in mind that Medicare fraud is not just a white collar crime In addition to stealing from the federal government quite often these providers are harming their patients either physically financially or both A recent case in Detroit Michigan is founded on accusations that a physician knowingly exposed patients to unnecessary chemotherapy treatments for the sole purpose of billing Medicare Pickert 2013 Closer to home in Chicago Illinois there is an ongoing case against a local hospital in which the government is alleging that in addition to receiving patient kickbacks the hospital performed tracheotomies for the sole purpose of billing the government for these services Federal Bureau of Investigation 2013Given the seriousness of these crimes it is necessary that healthcare administrators understand what Medicare fraud is and how it differs from Medicare abuse Next healthcare administrators should examine the Medicare fraud statutes to gain an operational understanding of these laws Finally they should understand the government-sanctioned Medicare fraud prevention agencies and partnerships that are in place to enforce these laws Medicare Fraud DefinedMedicare fraud According to George Pogazar 2012 Healthcare fraud involves an unlawful act generally deception for personal
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