| Papers [1-15] of 100 :: [Page 1 of 7] | | Go to page : 1 2 3 4 5 6 7 —> | Search results on "HEALTH INSURANCE FRAUD": |
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Health Insurance Fraud, 2004.
A look at the growing problem of medicare and medicaid insurance fraud and what can be done to prevent it.
7,463 words (approx. 29.9 pages), 21 sources, MLA, $ 164.95
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Abstract
This paper critically evaluates the statutes purposely passed to tackle medicare and medicaid insurance fraud. It also examines the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, as well as concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and the Mail and Wire Fraud Acts, and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.
Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Medicaid False Claims Statute
Penalties
Medicaid Anti-Kickback Statute
Sale of Physician Practices, Practitioner Recruitment and Obstetrical Malpractice Insurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud With General Federal Statutes
False Claims Act
False Statements
Mail and Wire Fraud
Conclusion
From the Paper
"An added safe harbor permits health plans with accords with CMS or a state health care program to give care for beneficiaries to augment coverage, decrease cost sharing amounts, or decrease premium amounts for enrollees under particular conditions. If the proposal is a competitive medical plan, health maintenance organization plan, prepaid health plan or any other plan with a contract with CMS or a state health care program, it has got to offer identical augmented coverage or reduced cost-sharing or payments to all Medicare or state health program enrollees unless CMS or the state endorses otherwise."
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Health Insurance Fraud, 2002.
An examination of government efforts to curb Medicare and Medicaid insurance fraud.
7,463 words (approx. 29.9 pages), 21 sources, APA, $ 164.95
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Abstract
This paper critically evaluates the statutes purposely passed to tackle Medicare and Medicaid insurance fraud. It evaluates the fundamentals, penalties, defenses, and safe harbor provisions for each and every statute, and concludes with a discussion of accessible legal safe harbor provisions. It discusses the wide-ranging federal statutes employed to impeach health care fraud, together with the False Claims, False Statements, and Mail and Wire Fraud Acts and explains the basics of the offenses, accessible defenses, and penalties valid under each statute. It also gives an indication of federal and state government agencies' pains to examine and take legal action against health care fraud.
Outline
Introduction
Statutes and Provisions Specifically Enacted to Address Medicare and Medicaid Fraud
Sale of Physician Practices, Practitioner Recruitment and Obstetrical Malpractice Insurance Subsidies
Contracts for Space, Equipment, Personal Services and Employment
Advertisements and Promotions
Referral Services
Relationships Between Providers
Arrangements Between Providers and Health Plans
Relationships Between Providers and Suppliers
Prosecuting Health Care Fraud with General Federal Statutes
Conclusion
From the Paper
"Individuals and organizations licensed by Department of Health and Human Services ("HHS") to accept imbursement under the Social Security Act may focus on Medicare and Medicaid fraud examinations (7). Persons, as well as organizations comprise nursing and rehabilitation centers, hospitals, Health Maintenance Organizations ("HMOs"), intermediate carriers for example private and public clinics, private insurance companies, durable medical equipment ("DME") providers, medical laboratories, physician practice groups, physicians, as well as other certified health care organizations (7)."
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Insurance Fraud, 2002.
An in-depth insight into insurance fraud, what it is, and what measures can be taken to prevent it.
10,871 words (approx. 43.5 pages), 18 sources, MLA, $ 215.95
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Abstract
This paper attempts to identify the different types of insurance fraud perpetrated today and to evaluate their effect on the insurance industry and society at large. After tax evasion, insurance fraud is considered the highest-ranked among white-collar crimes. It provides a history of insurance, examines in detail the main types of insurance frauds currently around and discusses the measures that can be taken to help prevent and reduce the number of fraudulent claims.
Table of contents:
Abstract
Introduction
History of Insurance
Insurance Fraud
How Insurance Frauds Affect Society
Classification of Fraud by Insurance Companies
Insurance Fraud Status as a Crime
Types of Insurance Frauds
Staged Auto Accidents
Arson-for-Profit
Health Insurance Fraud by Individuals and Corporations
Workers' Compensation Fraud
Property/ Casualty Insurance Fraud
Agent Fraud
Fake and Real Deaths to Collect Life Insurance Money
Identity Fraud
Efforts to Reduce Insurance Fraud
Conclusion
From the Paper
"One of the most famous insurance providers in the world today, Lloyd's of London came into existence in 1688. Edward Lloyd owned a coffeehouse in London where merchants and bankers evaluated the risk of the maritime operations of seafaring vessels used for trading among the various British colonies and those used for prospecting new lands. Financiers for the expensive endeavors and trips to far off lands invested huge amounts of money in the hope that the voyages would be successful. Ship captains required money for supplies and goods, and would offer to embark on these dangerous trips with the help of these financiers?a potentially, mutually beneficial endeavor."
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Automobile Insurance Fraud, 2005.
A paper examines the types of car insurance fraud typically committed.
2,025 words (approx. 8.1 pages), 5 sources, APA, $ 71.95
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Abstract
T|his paper explains the way to detect automobile insurance fraud and points out methods of investigating. The author relates sentencing for convicted fraud offenders. The paper reports the increasingly costly problem of auto insurance fraud.
From the Paper
"Americans pay an exorbitant amount of money each year to insure their vehicles for which they have also paid handsomely. ... Americans paid an estimated ... billion for auto insurance. Why are costs so high? One factor that plays into the soaring rates of automobile insurance is the dramatic increase in car insurance fraud. Consider this scenario. A typical driver is driving through town innocently minding their own business on the way to ..."
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The Cost of Insurance Fraud, 2002.
The paper discusses insurance fraud and how these costs are passed onto the consumer by way of higher premiums.
1,330 words (approx. 5.3 pages), 4 sources, MLA, $ 44.95
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Abstract
The paper defines insurance fraud and discusses the reasons why it is committed and the different ways in which it occurs. Methods to discourage the practice are presented. The paper then presents statistics showing how insurance fraud affects the consumer.
From the Paper
"A newly formed insurance advocate coalition studies 41 states in the nation for insurance fraud statistics. The statistics are alarming. Insurance fraud is currently costing Americans $80 billion a year. This works out to about $1,000 a family per year(Daily, 1998). One of the obstacles in the insurance fraud investigation efforts is the cost of the investigation. It is estimated that many fraud offices are lacking funds and personnel to effectively make a difference."
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Insurance Fraud, 2002.
Examines the pervasiveness of this type of crime in contemporary society.
1,689 words (approx. 6.8 pages), 6 sources, MLA, $ 54.95
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Abstract
After tax evasion, insurance fraud is considered the highest-ranked among white-collar crimes. After providing a brief history of the concept of insurance as a for-profit business, this paper explores the issue of insurance fraud. It discusses the three major categories of fraud in the insurance industry based on what side the perpetrator of the fraud is: claims fraud, applications fraud and fraud committed by employees in the insurance industry. The paper examines agencies that fight insurance fraud and discusses other means that society can rid itself of this type of crime.
From the Paper
"Insurers classify fraud as either ?hard? fraud or ?soft? fraud. When an accident, injury, theft, arson or any other loss is deliberately staged either individually or as a group to collect money from insurance companies the crime is classified as a hard fraud. It has been increasingly observed in recent times that organized crime groups and regional gangs are getting involved with more large-scale and intricate methods of swindling the insurance company using hard fraud methods. Innocent bystanders or individuals who are desperate for money may get involved with these staged accidents that may endanger their life and property."
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AIG Insurance Accounting Frauds, 2005.
This paper discusses frauds involving AIG and principles of accounting relating to the prevention of these frauds.
1,455 words (approx. 5.8 pages), 6 sources, MLA, $ 48.95
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Abstract
This paper explains that the American International Group--AIG, the world's largest insurer--was reported to have arranged deals to manipulate financial figure in its own records and those of General Re, a reinsurance company, resulting in financial fraud during the autumn of 2000. The author points out that AIG also was involved in another accounting fraud with Brightpoint Inc., which was reported by the Securities and Exchange Commission in 2003; AIG worked closely with the Brightpoint people to tailor an alleged insurance policy that let Brightpoint overstate its earnings by an amazing 61% in a cash circulation deal from Brightpoint to AIG and again back to Brightpoint. The paper defines receivables are monies due from the customers, which are tallied by invoices and happen due to operating cycle's process of selling inventory or services on terms that permit delivery before cash is collected.
Table of Contents
The General Re Fraud
The Brightpoint Fraud
Cash & Accrual Basis of Accounting
Receivables and Inventory
Fixed and Intangible Assets
Liability & Stockholders Equity
From the Paper
"Under the cash method of accounting, the books are maintained on the actual cash flow. Income is recorded on its receipt and expenses enter the books on their actual payment. Whereas majority of the businesses use the accrual basis, the most correct method for the company depends on the sales volume, credit policy of the company and business structure. In case of the accrual method, income & expenses are recorded while they occur, notwithstanding whether there has been exchange of cash and an example of this is sale on credit. Accrual method is appropriate when the annual sales are more than $5 million and the business is a corporate organization. Besides, it is suggested that while selling on credit, matching of income and expenses during a given period must be done."
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Health Care Fraud, 2002.
A look at the phenomenon of health care fraud and what can be done to fight this trend.
758 words (approx. 3.0 pages), 2 sources, MLA, $ 27.95
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Abstract
This research paper discusses health care fraud. It offers three examples of this fraud affecting the health care industry today. It explains that this kind of fraud is on the increase and manifested in several different forms. It discusses what the authorities are doing to combat this phenomenon.
From the Paper
"In the film Wall Street, financier Gordon Gecko proclaims, "Greed is good." It appears that a number of patients, health care providers, and others who handle financial transactions in the U.S. health care system, heartily endorse Gecko's philosophy. For up to $80 billion is stolen each year from taxpayers and insurers. Bolder scams arise all the time, and little is done to stop them. And as America's health-care bill spirals to an estimated $817 billion this year, it is attracting an ever more impudent and wily army of scam professionals. Experts now estimate that fraud and abuse in the health-care field cost somewhere between $50 billion and $80 billion each year?a figure that dwarfs the estimated $5 billion lost through criminal fraud in the entire savings and loan debacle. And of course, consumers and businesses are paying for these health-care rip-offs in higher taxes and skyrocketing insurance premiums (Friedman)."
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Health Care Fraud, 2002.
An essay on how health care fraud affects nursing homes.
900 words (approx. 3.6 pages), 3 sources, $ 35.95
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Abstract
This paper discusses the impact of the Health Care Fraud and Abuse Program on nursing home care in America.
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Fraud in Health Care, 2008.
This paper looks at cases of white-collar crime in the health care industry,
2,229 words (approx. 8.9 pages), 8 sources, APA, $ 69.95
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Abstract
The paper presents five case studies of health care fraud cases and related charges. The paper relates that in order to combat medical and health care fraud, the FBI has identified national initiatives to address frauds in the areas of medical transportation, durable medical equipment, hospital reporting costs, outpatient surgery centers, and pharmaceutical fraud.
Outline:
Introduction
The SEC and Carl Archer
Case studies and Examples
From the Paper
"Individuals at all levels within the health care and occupational industries--from receptionists to CEOS--are involved in health care fraud. Recent cases report that individuals from all areas within medical and health care organizations take advantage of the private information of their patients and clients in attempts to profit. Such crimes often involve additional offenses, including identity theft, tax evasion, corporate fraud, and other charges. Examples of white-collar crime appear in the media on a regular basis in all areas of the country, both rural and urban."
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Insured/Under-insured, 2004.
A comparison of the limitations of the U.S. health insurance system compared to other countries.
3,547 words (approx. 14.2 pages), 15 sources, MLA, $ 99.95
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Abstract
This paper attempts to address the question as to how U.S. should respond to the ongoing growth of uninsured and under-insured persons within the overall population. An overview is provided of the current health insurance system existing within the U.S., followed by a discussion of the factors that influence and are associated with the current system. It also examines the health insurance systems of other countries, which have been found to have better health outcomes than the U.S. It concludes with recommendations for the adoption of a universal health insurance system within the U.S.
Outline
Overview of the U.S. Health Insurance System
Factors Influencing Health Insurance in the U.S.
An Alternative U.S. Health Care System
Japan
Sweden
Canada
Summary and Conclusions
From the Paper
"As a component of the social insurance system in Sweden, health insurance and health care are financed via compulsory employers' contributions and individual social security contributions deducted from incomes (Swedish Institute, 2001). As further explained by the Swedish Institute, the 18 county councils that administer social insurance programs finance the costs of medical care directly from an income tax levied on all those living in the county who are in paid employment. According to the Swedish Institute, approximately 80 percent of tax revenues go to running the health care system and to subsidizing patient fees. Patients assume a proportion of the health costs when consulting a health care service, ranging from approximately 8 to 38 dollars. While all of Sweden?s residents are entitled to compensation for medical care, those individuals who have earned at least $750 annually through gainful employment are entitled to cash benefits for loss of income while ill."
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Introduction to Insurance, 2008.
Describes basic types of insurance, specifically life insurance and general insurance.
1,470 words (approx. 5.9 pages), 7 sources, APA, $ 48.95
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Abstract
This paper defines the two main types of insurance, namely, life insurance and general insurance. It points out that the main aim of insurance is to minimize the risks involved in various aspects of life and to cover and compensate the owner if any loss is suffered by the owner. The paper explains that general insurance involves fire and miscellaneous insurance, which covers a host of things ranging from burglary, theft, fidelity guarantee, live stock and crops, employer's liability and lastly insurance of motor vehicles. To conclude, the paper holds that insurance plays a pivotal role in minimizing risk and in compensating against the damage suffered.
Outline:
Introduction
Types of Insurance
Home Insurance
Health Insurance
Travel Insurance
Auto Insurance
Conclusion
From the Paper
"In life insurance the insurer agrees to pay compensation to the policy owner upon occurrence of an undesired event and the compensation is paid for the same, this undesired event can be death or accident or any other event which causes damage to the policy owner. In return the policy owner pays a premium, which can either be a stipulated amount or can be lump sum. There are many terms included in the most of the policies, one such common term is suicide, if the policy owner commits suicide the policy becomes null in other words the policy holder will be paid no compensation if he commits suicide. Another common term is the face amount; this is nothing but the initial amount which is paid by the insurer to the policy holder when the policy becomes mature."
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Facultative Re-Insurance Underwriting, 2006.
This well-researched paper defines and details the advantages and disadvantages of two particular forms of insurance currently available in America: Re-insurance and treaty re-insurance.
1,995 words (approx. 8.0 pages), 3 sources, APA, $ 63.95
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Abstract
The writer of this paper defines re-insurance as a basic method of underwriting insurance. Re-insurance falls mainly into two categories, the first being facultative re-insurance and treaty re-insurance, which are both handled by two separate companies. This paper details how both methods of insurance operate as well as how insured Americans are directly affected by these types of policies. This paper also discusses the individual risks involved with these forms of insurance as well as how downsizing and mergers have impacted the industry creating a shortage of qualified underwriters.
From the Paper
"One area where Facultative Re-insurers are concentrating their efforts both in training and research is in the environmental area. Here the losses from just one storm, or earthquake or any other natural disaster is very costly for all concerned. While this effort continues and as clean up after the fact of a disaster we're seeing such improvements as "storm resistant" construction, rapid rescue techniques, and many other improvements all precipitated by the Facultative Re-insurance Industry. And there are constant changes being made in order to reduce costs and improve life in general for the insured public."
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Metropolitan Life Insurance, 2004.
Examines fraud claims against the insurance company, Metropolitan Life.
885 words (approx. 3.5 pages), 6 sources, MLA, $ 31.95
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Abstract
In 1993, the Florida insurance department, along with the attorney general?s office, instituted an investigation into the sales practices of the Tampa office of Metropolitan Life. This prompted MetLife to conduct an internal investigation of its own, which led to the firing of several members of the staff. This paper looks at the past actions of Metropolitan Life Insurance Company and the possible future of the company.
From the Paper
"The Florida Insurance Commission stated that Metropolitan Life?s corrective action was appropriate, however continued with its own investigation and ordered ?Met to stop payment of executive compensation and sales bonuses until reserves were set up to cover fines and claims (Crosson).? The Florida Department of Insurance filed charges against Rick Urso and 86 other agents ?in connection with the sale of life insurance policies disguised as retirement plans (unknown, PR 1996).? The charges were dropped against Urso in 1996 on the condition that he stop working in the insurance field and allow his license to expire."
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Special Day Insurance, 2004.
This paper discusses the insurance industry and presents a business plan for a new coverage, ?Special Day? insurance.
5,555 words (approx. 22.2 pages), 8 sources, MLA, $ 135.95
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Abstract
This paper explains that most policies refer to one person as the ?named insured?; the entire insurance policy covers this person and the liabilities of this person, and nothing else. The author creates a new coverage, a special day insurance, which will protect the insurer when he organizes some of his own special days, such as birthdays, weddings, wedding anniversaries, public holidays, and celebrations of any nature; the only requirement will be that the function will have to be legal, and the insurance cover will lapse the moment any illegal activities are performed. The paper outlines the business plan including the marketing strategy for this sort of policy, through the media and sold through independent agents.
Table of Contents
Introduction
It has to be an Individual Policy
Insurance is a Dynamic Business
Purpose of the Insurance
How the Buyer Will Buy the Insurance
Advantages and Disadvantages of the Insurance
Potential Buyers and Reasons for Purchase
Similar Products
Pricing Strategy
Marketing Strategy
Promotional Plan
Potential Profits
Risks to the Seller
Administrative and Other Support Needed
Conclusion
From the Paper
"There are many examples how the insurance companies get around the problems of providing payments for the damages caused to those who are non-insured. This happens because the price of insurance has to be kept very low due to the competitive nature of the business. Let us take an example from the auto insurance business. Here in some cases, only the named insured has to give permission to others for the use of the vehicle. Here the definition of the person who is permitted is given as ?Anyone else while using with your permission a covered auto you own hire or borrow?. The definition of the ?you? has also been given. ?Throughout this policy the words ?you? and ?your? refer to the Named Insured shown in the Declarations.? This may create quite a confusing situation. If there is a vehicle, which has the owner as ?Bradley Inc? and that entity is the named insured."
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