Financial Health 3 Assignment Example | Topics and Well Written Essays - 750 words

Financial Health 3 - Assignment Example This Act also provides for punishment for whomever knowingly and willfully offers to pay any person in order to persuade the person to refer them to a provider who can furnish items or services for which payment would the fall under Medicare and Medicaid guidelines and be payable as such. Certain exceptions are allowed such as certain discounts given by suppliers to cost-reporting providers. Operation Restore Trust is an initiative that was created to combat fraud, eliminate waste, and monitor abuse in the Medicare and Medicaid programs. Operation Restore Trust was established by the Department of Health and Human Services. The Office of the Inspector General understands the health care delivery system has always been vulnerable to fraud and in response the OIG has placed emphasis on interdisciplinary teamwork. OIG worked jointly to create a project which would detect cases of abuse and fraud that occur through home health agencies, in nursing homes, and with durable medical equipment suppliers. OIG worked in partnership with the Administration on Aging and the Health Care Financing Administration. Projects included audits and evaluations of claims by home health agencies, administrative costs claimed, periodic interim payments to home health agencies, variations among home health care coverage Medicare payments, to name but a few. Ongoing evaluations and audits include services provided to Medicare and Medicaid beneficiaries in nursing homes, durable medical equipment payments in nursing homes, and outreach activities include fraud alerts and a hotline to report fraudulent activity (Brown, 1995). The Centers for Medicaid and Medicare services goals’ are to combat provider fraud, waste and abuse. The two broad responsibilities of the Medicaid Integrity Program include hiring contractors to review the actions of providers, identify when there have been