Introduction to Public Health Insurance Assignment (1)

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Introduction to Public Health Insurance Assignment Nikolas Sullivan (L34020706) School of Health Sciences: Liberty University AMOA 206: Medical Office Billing and Bookkeeping Dr. Karen Davidson February 05, 2024

Introduction to Public Health Insurance Assignment In the United States, Medicare and Medicaid are two essential public health insurance systems. Nevertheless, there have been cases of fraud and misuse in these schemes, which compromise their integrity and cause significant financial losses. Knowing what to do in the event of Medicare or Medicaid insurance fraud or abuse is critical. This essay will examine the moral, legal, and Christian implications of reporting these occurrences and offer three examples to support the conclusion. Legal Aspect: Reporting fraud and abuse involving Medicare or Medicaid insurance is not only the right thing to do but is also required by law. The False Claims Act (FCA) encourages whistleblowers and allows people to expose fraud against government programs. Significant fines and penalties may apply to anyone violating the FCA ( Anderson, 2019). Ignoring fraud or abuse might have legal repercussions; however, reporting such events ensures responsibility within the system and respect for the law. Moral Considerations: Reporting fraud and abuse involving Medicare and Medicaid insurance is consistent with the moral precepts of justice, equity, and truthfulness. By stealing resources from people who need them, dishonest behaviors deprive disadvantaged populations of essential healthcare services. People may help ensure that resources are distributed more fairly and preserve the integrity of publicly financed insurance programs by reporting fraud. Furthermore, disclosing fraud and abuse supports healthcare workers' ethical obligation to act in the public's and patient's best interests. Healthcare professionals who commit fraud jeopardize patient treatment and negatively erode public confidence in the healthcare system.

Introduction to Public Health Insurance Assignment impacts the community’s general well-being. Reporting such instances fulfills the ethical duty to prioritize patient safety, high-quality treatment, and general welfare. Christian Perspective: A Christian ethic of justice, stewardship, and truth guides the investigation of Medicare and Medicaid insurance fraud. Christians are expected to live honorably and honestly, including disclosing wrongdoing. Dishonesty tarnishes one's Christian witness if these values are violated. In opposing fraud and abuse, people reflect God's commitment to truth and morality. Example: A medical practitioner encounters a colleague who frequently overstates the seriousness of a patient’s ailments to obtain larger Medicare payouts. Upon recognizing the dishonest activity, the person reports the situation, realizing it is their moral, legal, and religious obligation. A Medicaid billing office employee discovers anomalies wherein some people are wrongly charged for treatments they did not obtain. The worker chooses to compile proof and denounce the false invoicing practices because they believe it is their responsibility to safeguard public dollars and guarantee that Medicaid resources are provided to people who need them. A Medicare-eligible patient discovers that their healthcare professional is submitting an invoice for unfulfilled services. The patient reports the fraudulent conduct because they believe it is their moral duty to promote integrity, equity, and the prudent use of public monies.

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Introduction to Public Health Insurance Assignment Conclusion: People must report and take proper action when facing Medicare or Medicaid insurance fraud or abuse. This is following moral and legal requirements and Christian beliefs. People may contribute to maintaining the integrity of public health insurance schemes, ensuring equitable resource allocation, and safeguarding vulnerable populations by reporting fraud and abuse. In the end, disclosing fraud advances stewardship, justice, and integrity, which benefits a more equitable and healthy society.

Introduction to Public Health Insurance Assignment References Varda, D.M., & amp; Escudero, D. J. (2021). Health care fraud and abuse: A systematic review of perspectives on definitions and interventions. Journal of Behavior Medicine, 44(4), 496-513. Trinitapoli, J., & amp; Ellison, C. G. (2020). What Lies Beneath? Religion, Moral Attitudes, and Public Opinion about Fraud in Sub-Saharan Africa. Anderson, D. S. (2019). The False Claims Act: Overview and Recent Developments. Congressional Research Services. Charo, R. A. (2019). The ethics of Medicaid expansion and the fate of the uninsured. The Hastings Center Report, 49(S1), S7-S12, Pellegrino, E. E., & Thomasma, D. C. (2017). The Christian virtues in the medical practice. Oxford University Press. Zhang, C., Xiao, X., Wu, C., & Wu, C. (2020). Medical Fraud and Abuse Detection System Based on Machine Learning. International Journal of Environmental Research and Public Health, 17(19), 7265.

Introduction to Public Health Insurance Assignment (1)

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