The history of/eliminating fraud and abuse in health care

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Eliminating Fraud and Abuse in Health Care Name Institution Abstract The demand for health care is growing at an exponential rate, but access is controlled by willingness and ability to pay, cost and availability of the care, which creates an opportunity for both fraud and abuse. This is based on the understanding that health care fraud and abuse are unethical practices that increase costs by benefiting the perpetrators who benefit from the subject transaction while having an adverse effect on the other stakeholders who did not participate in the transaction. It has been noted that fraud and abuse are caused by competition, need to improve market position, local cultures, and the need to protect local investments by engaging in quid pro quo trade. Given that fraud and abuse have a negative impact on health care access and costs, not to mention being unethical practices, it is understandable that these practices should be curtailed. The unethical practices should be curtailed through greater oversight, inclusion, and control. In addition, they should be addressed by setting up clear rules on acceptable conduct, better policing, and stiffer penalties for the perpetrators of the corrupt practices. Overall, the incentive for fraud and abuse should be reduced through sanctions and audits so as to improve health care access and costs. Eliminating Fraud and Abuse in Health Care Introduction The demand for medical care is growing at an exponential rate and is dependent on the observed need and utility of health care services as noted in population-based statistics. In spite of the snowballing demand for health care, access is managed by the willingness and ability

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