Utilizing at least two scholarly sources and a biblical integration, please reply to the below post:
Allison Scott
Fraud and Abuse
COLLAPSE
Fraud and abuse is common in every aspect of life. The difference between the two is, fraud is a deliberate, intentional act of deception and abuse is an improper act that could be unintentional.
One example of fraud in the United States healthcare was when several Doctors in 2012 were using Medicare to their benefit. Other action, via a joint effort between HHS and the Department of Justice, the Health Care Fraud Prevention and Enforcement Action Team’s Medicare Fraud Strike Force, resulted in 198 doctors, nurses, and other licensed medical professionals in multiple cities being charged for allegedly participating in schemes to defraud Medicare of more than $884 million through false billing (Sullivan, et. al., 2019) The overall outcome of the $884 million fraud case was providers being identified as high risk and requiring fingerprints and background checks, penalties for members who obstruct fraud, increases in sentences and jail times.
One aspect of abuse is gun decking which is charting down false information. However, I used the following example because I see where it could be unintentional. Rndahl mentions examples of standard paper documents that offended homosexual patients by assuming heterosexuality which clearly lack any direct intentions. AHC can also involve intentional harm which is likely to increase patient suffering. A characteristic (intent) that is most often lacking may be an odd kind of attribute. However, the possible lack of intention is distinct for AHC as it differentiates AHC from dictionary definitions of abuse as it most often does not benefit anyone and therefore is important to emphasize (Bruggemann et. al., 2011) The outcome of this was ensuring documentation is correct that way patients do not take offense of feel abused by the wrong information. Blood pressures, medications, ethnicity, all of this needs to be correct when documented.
The role of healthcare managers in fraud and abuse cases is to prevent them. Healthcare managers should be familiar with the health care laws, and pass the education and training onto all other staff members. If a healthcare manager is engaged in the workplace- familiar with billing and documentation, referrals, etc. then there is a higher chance of bringing awareness of fraud and abuse when its taking place. Since a healthcare manager is essentially the glue for the work center, if he/she notices something they need to speak up to it doesnt affect the rest of the staff and the patients. Healthcare managers should also be familiar with programs and policies to know how to properly report fraud and abuse and hold people accountable.
Wealth gained hastily will dwindle, but whoever gathers little by little will increase it. (Proverbs 13:11)
Openbible.com Retrieved from What Does the Bible Say About Fraud? (openbible.info)
Sullivan, C., & Hull, H. (2019). PRESERVING LIFE AND HEALTH BY PREVENTING FRAUD IN HEALTHCARE. Journal of Business and Behavioral Sciences, 31(1), 48-58.
http://ezproxy.liberty.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fpreserving-life-health-preventing-fraud%2Fdocview%2F2248942140%2Fse-2%3Faccountid%3D12085
Bruggemann, A. J., Wijma, B., & Swahnberg, K. (2012) Abuse in health care: A concept analysis. Scandinavian Journal of Caring Sciences, 26(1), 123-132.Abuse in health care: a concept analysis – Brggemann – 2012 – Scandinavian Journal of Caring Sciences – Wiley Online Library (liberty.edu)
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