Navigation Links
New Analysis Examines Fraud in Both Private and Public Health Insurance Markets
Date:6/26/2009

WASHINGTON, June 26 /PRNewswire/ -- A new report from The George Washington University School of Public Health and Health Services, Department of Health Policy challenges the notion that fraud is a problem only in public health insurance markets and finds that fraud is a system-wide problem affecting private and public health insurance alike. The report finds that some of the most striking examples of fraud come from fraud committed directly by the private insurance industry itself. In 2007, when the U.S. spent nearly $2.3 trillion on health care and public and private insurers processed more than 4 billion health insurance claims, fraud was estimated to reach as much as 10 percent of annual health care spending. At this rate, the losses in 2007 alone -over $220 billion - would have been enough to cover the uninsured. The National Health Care Anti-Fraud Association (NHCAA) has estimated conservatively that 3 percent of all health care spending--or $68 billion--is lost to health care fraud.

The report finds that no segment of the health care industry or geographical area is immune from fraud. It is estimated that 80 percent of healthcare fraud is committed by medical providers, 10 percent by consumers, and the balance by others, such as insurers themselves and their employees. Fraudulent billing, kickbacks, up-coding services and bundling are common examples of fraud. Avoidance of sick and high need members, along with the systematic misrepresentation of the cost of care to group plan sponsors, represent major examples of fraud in the private insurance industry.

The report also notes the distinction between fraud and improper payments. Fraud is a misrepresentation of the truth or concealment of material facts. Improper payments, on the other hand, tend to involve technical questions associated with verification of claims or related matters. The report also describes recent efforts to improve fraud detection and
'/>"/>

SOURCE George Washington University
Copyright©2009 PR Newswire.
All rights reserved

0

GOOD

Page: 1 2 3

Related medicine news :

1. Study, meta-analysis examine factors associated with death from heatstroke
2. Latest DES Analysis Stresses Importance of Physicians Well-Trained in Implantation Technique and Patient Follow-Up
3. Consumer Reports Analysis: Drugs for Nerve Pain, Fibromyalgia Effective, But Not Always Best
4. Takeda statement on ACTOS meta-analysis published in the Journal of the American Medical Association
5. Takeda Statement on ACTOS(R) (Pioglitazone HCl) Meta-Analysis Published in the Journal of the American Medical Association
6. Physical Therapist Provides Injury Analysis for Fantasy Football
7. Sanofi-Aventis renews licenses for Genomatix chip analysis pipeline
8. Meta-Analysis of Blood Phe Levels and Clinical Outcomes in PKU Published
9. OCS and Press Ganey Partner to Create Joint Analysis of Outcomes and Satisfaction
10. New Analysis Underscores Legality of Physician Ranking and Public Reporting Systems When Used by Health Insurers to Improve Health Care Quality
11. Barta joins Conseco as Senior Vice President, Financial Planning & Analysis; Barra named Senior Vice President, Internal Audit; Clarke to head Investor Relations
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/23/2013)... May 23, 2013 Medical device development ... the Sheikh Zayed Institute for Pediatric Surgical Innovation at ... Annual Pediatric Surgical Innovation Symposium will be held June ... It will address critical issues in pediatric surgical ... are available on the Sheikh Zayed Institute website. ...
(Date:5/23/2013)... (PRWEB) May 23, 2013 Dr. ... their condition specific remedies are now available at Whole ... Niguel, CA 92677. The line of natural biotherapy formulas ... Market Chain. , Represented by Brandstorm HBC (Los Angeles, ... Foods Markets throughout California, Nevada and Arizona, as well ...
(Date:5/23/2013)... After working continuously for weeks and ... Shopping Cart Elite officially announced the launch ... Arizona based online store retailing in wheels, seats, parts, ... new stores to our clientele has always been our ... Soshkin. “We are extremely elated with this addition as ...
(Date:5/23/2013)... 23, 2013 FindUrgentCare.com launched updates to ... search option for patients. The new advanced feature ... including payment preferences, offered services, insurances accepted and hours ... way to narrow their search and receive targeted results ... provide ambulatory care to walk-in patients in a non-emergency, ...
(Date:5/23/2013)... (PRWEB) May 23, 2013 Greenville ... that all team members and doctors have recently ... professional rescuer with an Automated External Defibrillator (AED). ... (AED) is a medical device designed to analyze ... to victims of ventricular fibrillation to restore the ...
Breaking Medicine News(10 mins):Health News:Children’s National to Host Symposium on Medical Device Development 2Health News:Dr. Garber's Natural Solutions Now Available at Whole Foods Market, Laguna Niguel, CA 2Health News:Shopping Cart Software Provider, Shopping Cart Elite Officially Announces the Launch Of Redsandmotorsports.com 2Health News:Find Urgent Care Launches New Site Design and Functionality to Provide Advanced Search Options for Users in Need of an Urgent Care Clinic 2Health News:Find Urgent Care Launches New Site Design and Functionality to Provide Advanced Search Options for Users in Need of an Urgent Care Clinic 3Health News:Greenville Oral & Maxillofacial Surgeons Announce CPR Re-Certification 2
... Common Shares Issued and Listed on OTCBB, ... (OTC Bullets and Board: CHHB) (,China,Bio-Immunity" or "the ... share exchange agreement with Lawford Asia Limited (,Lawford,).,According ... all of the issued and outstanding stock of ...
... Grant Stevens, MERRIMACK, N.H., Aug. 6 ... Medical Inc. announced today that Grant,Stevens, MD, will ... to offer,the SmoothShapes(R) system for longer lasting cellulite ... dynamic light therapy, in addition,to contoured rollers and ...
... eDiets.com,Inc. (Nasdaq: DIET ), leveraging the power of ... to everyone, today announced,results for the second quarter and ... the second quarter of 2008 were $6.5 million, compared ... for the quarter was $(3.1),million, or $(0.12) per diluted ...
... Raritan, NJ, August 6, 2008 The nation,s first, ... (cSSTIs), known as SSTIR (the Skin and Soft Tissue ... plans to enroll more than 1,200 hospitalized patients by ... better understand treatment patterns and provide data to help ...
... study finds , , WEDNESDAY, Aug. 6 (HealthDay News) -- Stroke ... times as likely to die in the hospital or be ... new Canadian study suggests. , The finding is based ... recovery from an ischemic stroke. Ischemic strokes are the most ...
... than to adults. That,s one reason why abstinence-only ... sexual activity, according to new University of Washington research., , ... treated abstinence and sexual activity as opposites. However, teenagers ... Tatiana Masters, lead author of a new study and ...
Cached Medicine News:Health News:China Bio-Immunity Corporation Completes Share Exchange and Reverse Merger 2Health News:China Bio-Immunity Corporation Completes Share Exchange and Reverse Merger 3Health News:China Bio-Immunity Corporation Completes Share Exchange and Reverse Merger 4Health News:New Anti-Cellulite Treatment Prepares Women for Fall's Short Skirts 2Health News:New Anti-Cellulite Treatment Prepares Women for Fall's Short Skirts 3Health News:eDiets.com(R) Announces Q2 2008 Results 2Health News:eDiets.com(R) Announces Q2 2008 Results 3Health News:eDiets.com(R) Announces Q2 2008 Results 4Health News:eDiets.com(R) Announces Q2 2008 Results 5Health News:eDiets.com(R) Announces Q2 2008 Results 6Health News:eDiets.com(R) Announces Q2 2008 Results 7Health News:Ortho-McNeil initiates first-of-its-kind skin infection registry 2Health News:GI Bleeding After Stroke Raises Death Risk 2Health News:GI Bleeding After Stroke Raises Death Risk 3Health News:When it comes to abstinence teens, adults aren't speaking the same language 2Health News:When it comes to abstinence teens, adults aren't speaking the same language 3
(Date:5/23/2013)... NEW YORK , May 23, 2013  Echo ... has committed to waive down the Acceptance Threshold from ... Affected plus one Elan Share in accordance with the ... to the conditions summarized below. Under the ... to acquire Elan (NYSE: ELN ) for ...
(Date:5/23/2013)... 23, 2013 Nederland keurt als ... urinewegsymptomen geassocieerd met BPH Astellas Pharma ... Astellas Pharma Inc, gebaseerd in Tokyo ... aan dat het Nederlandse College ter Beoordeling van Geneesmiddelen ... De handelsvergunning verleend voor VESOMNI is voor ...
(Date:5/22/2013)... , May 22, 2013 Advanced Prenatal Therapeutics ... device that will help alleviate the high blood pressure ... cartridge is expected to be the first medical device ... maternal and fetal death. Every year, preeclampsia ... United States . It is characterized by high ...
Breaking Medicine Technology:Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 2Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 3Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 4Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 5Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 6Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 7Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 8Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 9Royalty Pharma Reduces Acceptance Condition to 50% Plus One Share 10Astellas ontvangt handelsvergunning voor VESOMNITM van Nederlandse College ter Beoordeling van Geneesmiddelen 2Astellas ontvangt handelsvergunning voor VESOMNITM van Nederlandse College ter Beoordeling van Geneesmiddelen 3Astellas ontvangt handelsvergunning voor VESOMNITM van Nederlandse College ter Beoordeling van Geneesmiddelen 4Advanced Prenatal Therapeutics - Using Targeted Apheresis to Treat Preeclampsia 2
... , Elsevier,s Pageburst platform to be ... Program Elsevier, the leading global provider of ... today that West Kentucky Community and Technical College ... Technical College System and a public, two-year, degree-granting institution ...
... patent covering tumor suppression technologies, including the company,s lead ... The University of Texas System by the ... discovery that chromosome 3p21.3 genes act as cancer suppressors. ... as FUS1, the anti-cancer agent in Oncoprex ...
Cached Medicine Technology:West Kentucky Community and Technical College Embraces Elsevier's Digital Textbook Platform for Radiography Program 2West Kentucky Community and Technical College Embraces Elsevier's Digital Textbook Platform for Radiography Program 3Genprex Announces New Patent Issuance in Japan 2
Bartels Clostridium difficile Toxin A Enzyme Immunoassay (EIA) is intended for the qualitative detection of Clostridium difficile Toxin A in human faecal specimens as an aid in the diagnosis of Clost...
One step Immuno-Chromatographic Assay for the detection of C. difficile toxin A....
... CCD cameras provide fast, accurate, reliable and ... quality at an excellent price. , , ... TOMEY TR-4000 Auto Refractor provides highly accurate ... is obtained simply by pushing a button. ...
... Rechargeable, cordless slit-lamp microscope Portable, for ... Easy selection of slit width , ... halogen lamp light source , Simultaneous ... pack , Supports digital / video ...
Medicine Products: