Health Care Fraud Control

Fraud Health Care
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Fraud in Health Care
Over the years the health care sector has suffered massive losses due to fraudulent operatives that take advantage of the systems flaws. Billions of taxpayers’ money is lost through fraudsters that want to take money from seniors or individuals and companies that want to take money that is not entitled to them (Hhs.gov, 2015). Over the course of Obama’s presidency, he has made every effort to streamline the health care sector, by offering quality health care services to masses that did not have access to the same.
Part of these efforts have been directed at developing and enacting laws that safe guard the health care sector either by offering better services and reducing the incidences of fraud (Hhs.gov, 2015). The Fraud Enforcement Recovery Act and the Patient Protection and Affordable Care Act are some of the legislations that have been passed during his administration that oversee the health care delivery across the nation (Pattonboggs.com, 2015).
Impacts The Fraud Enforcement and Recovery Act of 2009 (FERA) and The Patient Protection and Affordable Care Act (ACA) on health care fraud
1 The Fraud Enforcement and Recovery Act of 2009 (FERA)
This is a law that was enacted by the siting president, President Obama on the 20th of May in the year 2009. There were previous Acts that covered the aspects of fraud especially in the case mortgage and securities (Pattonboggs.com, 2015). However, FERA was not enacted to create conflict with these legislations but to enhance them and expand their reach. One of those reaches is within the health care sector which has been marred with consistent fraud. With the advent of the FERA, the congress now had a chance to revise the False Claims Act, which handles the aspects of people defrauding insurance industry especially in relation to health care and defense. False claims are some of the loopholes that fraudsters have been using to make money out of the gaps in the system.
Under the FERA procedural requirement and those of the revised FCA, grantees, contractors as well as recipients of federal funds are subjected to better scrutiny to ensure transparency. The act further covers contractors and their subcontractors to ensure that the later do not defraud the former. There are quarterly reports that the two entities have to submit to the government, in which case if the subcontractor fraudulent, they will be liable to the FCA.
In the past the retention of overpayments and the reverse of false claims did not take much precedence. It was generally assumed that if one received overpayment, they ...