287, any health care provider who presents a false or fictitious claim or demand to the government seeking reimbursement for medical goods or services can be liable. The prosecutor need only prove that the provider intentionally submitted the claim knowing that it was false, fictitious or fraudulent (Bennett, 2007)
Approximately $60 billion of the total costs of healthcare fraud have been linked to Medicaid and Medicare, at direct cost to taxpayers (Taitsman 2011). "Since 1990, the Government Accountability Office (GAO) has designated Medicare as a high-risk federal program because its vast size and complexity make it vulnerable to fraud, waste, and abuse" (Iglehart 2010)
According to a 2009 CBS News report: "One tiny pharmacy in a Hialeah [Florida] strip mall went from billing Medicare $13,000 in May to billing nearly a million dollars a month later," and regulators took no notice (Rosen & Bach 2009:1). It has been estimated by the Federal Bureau of Investigation (FBI) the fraudulent billings to public and private health care programs are 3 -- 10% of total health spending, $75 -- $250 billion per year on average, and that is only the fraud that is currently known (Morris 2009: 1351)
Although federal authorities have tried to grow more vigilant, health care fraud is becoming increasingly difficult to detect. Approximately $60 billion of the total costs of healthcare fraud have been linked to Medicaid and Medicare, at direct cost to taxpayers (Taitsman 2011)
Medicaid and Medicare Fraud Describe health news story combating health care fraud Medicare Medicaid• Examine evaluate corporate structure governance, culture, focus social responsibility • Recommends Medicare and Medicaid fraud: An overview Medicare and Medicaid fraud: An overview While there is still little consensus regarding the best ways to go about enacting healthcare reform, one issue that unites both Democrats and Republicans is the need to eliminate Medicaid and Medicare waste, fraud and abuse. According to a 2009 CBS News report: "One tiny pharmacy in a Hialeah [Florida] strip mall went from billing Medicare $13,000 in May to billing nearly a million dollars a month later," and regulators took no notice (Rosen & Bach 2009:1)