The United States healthcare system is facing serious financial issues that are causing many hospitals to either have to file bankruptcy or even shut down. In the past 6 years, over 50 hospitals has closed down, with many more following. One major issue for healthcare would be financial fraud. Many organizations are losing big money from the amount of fraudulent insurance claims being filed. According to The National Health Care Anti-Fraud Association( NHCAA), the estimated financial lost from healthcare fraud are in the tens of billions each year. Most of the schemes are done on regular Americans like you and I that really need healthcare. This is making it difficult for patients to trust healthcare professionals with their personal information.
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Doctors would perform unnecessary treatments on patients and over charge them, bill patients for services never provided by using patients information obtained from identify theft to make the claims, changing plastic surgery procedures from non-covered treatments to medically necessary treatments for the insurance money, billing patients for each step of a procedure as if it was separate when in fact it was apart of the same procedure, along with a list of other things. This happens partly because people who have low income and have medicaid or medicare and are old or young, are not educated enough to know and understand the billing and the charges billed to them. Its easy for providers to get over on people because people trust the doctors and medical professionals. They believe that what they are being told is the truth and that it in their best interest, when in fact, it’s not. Most people on medicaid and medicare, do not get the change to see the bill, it goes straight from the hospital to the insurance company, therefor theres no one to question that …show more content…
June 2016, over 300 individuals were charged with $900 million dollars in false billing. (Berlinger 2016) According to CNN, this was the biggest bust ever in both the amount of people involved and the total amount lost. 61 of the 300 people were medical professionals, 36 were federal judicial districts and 28 were doctors along with other people. These crimes were mostly in Florida, New York, Michigan, California and Texas. HHS Department inspector general suggest that home health care agencies were the main targets for over billing and adding services to the bill that was not provided worth up to $10 billion dollars in 2015. Things like this plays a big part in why healthcare is not affordable for most Americans
Doctors would perform unnecessary treatments on patients and over charge them, bill patients for services never provided by using patients information obtained from identify theft to make the claims, changing plastic surgery procedures from non-covered treatments to medically necessary treatments for the insurance money, billing patients for each step of a procedure as if it was separate when in fact it was apart of the same procedure, along with a list of other things. This happens partly because people who have low income and have medicaid or medicare and are old or young, are not educated enough to know and understand the billing and the charges billed to them. Its easy for providers to get over on people because people trust the doctors and medical professionals. They believe that what they are being told is the truth and that it in their best interest, when in fact, it’s not. Most people on medicaid and medicare, do not get the change to see the bill, it goes straight from the hospital to the insurance company, therefor theres no one to question that …show more content…
June 2016, over 300 individuals were charged with $900 million dollars in false billing. (Berlinger 2016) According to CNN, this was the biggest bust ever in both the amount of people involved and the total amount lost. 61 of the 300 people were medical professionals, 36 were federal judicial districts and 28 were doctors along with other people. These crimes were mostly in Florida, New York, Michigan, California and Texas. HHS Department inspector general suggest that home health care agencies were the main targets for over billing and adding services to the bill that was not provided worth up to $10 billion dollars in 2015. Things like this plays a big part in why healthcare is not affordable for most Americans