Hcs 455 The Policy Process Analysis
The Policy Process: Evaluation, Analysis, and Revision
Barbie Tucker
HCS/455
6/15/15
James McManus
There are many stages in the policy making process. In the fight of fraud and abuse of healthcare programs, Congress implemented the Health Care Fraud and Abuse Control (HCFAC) in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (GAO, 2011). Policies are always evaluated to find solutions to issues which arise in policies. The analysis done to see if the policy receives positive outcomes and detect the negative outcomes to help in the revising of the policy. The understanding of the stages in policy making can determine if the policy will be a success or a failure which the policy may be terminated all …show more content…
The continuance of misrepresentation of services with incorrect CPT codes, billing services not rendered, altering claim forms for higher payments, falsification of information on forms, misrepresentation of services that was not performed or the type of service, billing for not supplies used, and providing medical services that are not needed these performances will cost the taxpayer money as well as the government. To meet the objective of the fraud and abuse policy is difficult because of the lack of detecting the crime. To help in the decreasing of the fraud and abuse there has been more enforcement of the False Claims Act of 1986 which as of 2007 there has been over $11.2 billion dollars collected in fraudulent claims. The increased of surveillance has resulted in a positive outcome of health care savings of $39 billion dollars. (AHIMA, …show more content…
These could be implanted in the fraud and abuse policy where health care facilities will have to abide by the regulation to decrease the chance of fraud and abuse in the health care industry. Although there are policies for different agendas not all are maintain as policies.
They can be terminated if the data does not support the policy or failure to have revisions done to solve the problems. The continuance of combating fraud and abuse must be a teamwork effort of physicians, health care provider, organizational, and federal levels. The responsibility, ownership, and consequences for actions should be frequently communicated to the health care industry for more positive outcomes of reducing fraud and
Barbie Tucker
HCS/455
6/15/15
James McManus
There are many stages in the policy making process. In the fight of fraud and abuse of healthcare programs, Congress implemented the Health Care Fraud and Abuse Control (HCFAC) in the Health Insurance Portability and Accountability Act of 1996 (HIPAA). (GAO, 2011). Policies are always evaluated to find solutions to issues which arise in policies. The analysis done to see if the policy receives positive outcomes and detect the negative outcomes to help in the revising of the policy. The understanding of the stages in policy making can determine if the policy will be a success or a failure which the policy may be terminated all …show more content…
The continuance of misrepresentation of services with incorrect CPT codes, billing services not rendered, altering claim forms for higher payments, falsification of information on forms, misrepresentation of services that was not performed or the type of service, billing for not supplies used, and providing medical services that are not needed these performances will cost the taxpayer money as well as the government. To meet the objective of the fraud and abuse policy is difficult because of the lack of detecting the crime. To help in the decreasing of the fraud and abuse there has been more enforcement of the False Claims Act of 1986 which as of 2007 there has been over $11.2 billion dollars collected in fraudulent claims. The increased of surveillance has resulted in a positive outcome of health care savings of $39 billion dollars. (AHIMA, …show more content…
These could be implanted in the fraud and abuse policy where health care facilities will have to abide by the regulation to decrease the chance of fraud and abuse in the health care industry. Although there are policies for different agendas not all are maintain as policies.
They can be terminated if the data does not support the policy or failure to have revisions done to solve the problems. The continuance of combating fraud and abuse must be a teamwork effort of physicians, health care provider, organizational, and federal levels. The responsibility, ownership, and consequences for actions should be frequently communicated to the health care industry for more positive outcomes of reducing fraud and