Fraud and Abuse Case

Healthcare fraud and abuse continues to threaten the country, costing the facility billions of dollars per year. Brodeur, (2007) stated that fraud is something difficult to understand because it is a contagious issue. Healthcare fraud and abuse according to Brosman & Roper (2007) is the most profitable thing one can take part in if he/she is a crook, it avoid all channels and legal procedures, in nutshell, have no hurdles.

Commonly types of healthcare fraud and abuse cases are revealed where one bill for services not offered, up coding which refers to hiking bills with intention to get higher reimbursement increment. Unbundling which entails submission of separate bills for single component of an activity for example billing independently for categories of laboratory tests done together with the aim of getting high reimbursement. These fraud activities are against compliance laws and regulations and it is unethical and...
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