Healthcare Fraud and Abuse

In this assignment you will have an opportunity to review an annual report produced by the Department of Justice. The report summarizes compliance activities conducted by Federal agencies and the outcomes of cases which have been prosecuted.

Abuse and complete the questions using information found within the Annual Report attached (below).

The department of justice healthcare fraud and abuse control program annual report for 2015.

Questions

Provide your answer(s)beneath each question as indicated.

1. HIPAA established a national Healthcare Fraud and Abuse _________Program (HCFACP).

2. HCFACP is under the control of the Attorney General and the Secretary of the Department of _________and _________Services (HHS).

3. They identify and prosecute the most egregious instances of healthcare fraud, to _________future fraud and abuse and to protect program _________.

4. In 2015, a total of _________defendants were convicted of healthcare fraud and related crimes.

5. HHS also excluded _________individuals and entities from participating in Medicare, Medicaid and other federal healthcare programs.

6. Thought Question:

In question 5 above, consider what ‘individuals' (for example physicians, nurses and occupational therapists) and ‘entities' (for example clinics, diagnostic laboratories and ambulance companies) mean. The sentence indicates that the illegal actions that convicted them of fraudulent healthcare activities have resulted in them being excluded from participation in Medicare, Medicaid and other federal healthcare programs. Explain why this penalty is critically damaging to their professional healthcare futures.

7. Locate the table titled: "Monetary Results: Total Transfers/Deposits, FY 2015" and record the $ amount of Restitution/Compensatory Damages $ _________.

8. In the same table, locate the $ amount for Relator payments $_________.

9. In the same table, see the ** after Relator and record who these funds were awarded to: _________.

10. See The Mission of the Healthcare Fraud Prevention and Enforcement Action Team. Part of it says ‘crackdown on_________costing us all billions of dollars.

11. The Medicare Fraud Strike Force was launched in 2007 to investigate and prosecute fraud in southern Florida. It later expanded to cover nine areas. Name 4 of the 5 states listed: