Unit 1 Assignment – Healthcare Fraud and Abuse

Title of Press Release

Prison Health Care Provider Naphcare Agrees To Settle False Claims
Act Allegations

Summary of Press Release

Naphcare located in Birmingham Alabama that sub-contracts with providers to
provide care for inmates across the United States who are housed in the Federal
Bureau of Prisons have allegedly violated the False Claims Act. Between January
2014 through June 2020 they alleged submitted inflated claims for higher-level of
care service than providers really performed at a facility in Indiana and Victorville
California. The claims where questioned when some providers failed to indicate
the type of onsite service they provided. Naphcare has agreed to pay the sum of
694,593 to settle and resolve all the allegations that they violated the False claim
Act.

Title of Federal Fraud and Abuse Law

Health care Fraud False Claim Act

Summary of Federal Fraud and Abuse Law

The false claim act was passed in 1863 president Lincoln urged congress to pass
that is why it is also referred to Lincoln Law, after a period of it being dormant
amendments that were made in 2009 and 2010 strengthened the statue. Any
person, or entity knowingly presents, or causes a false or fraudulent claim to
government for payment or for an approval or fails to repay money or return
property to the government, as well as anyone who conspires to commit the fraud
is in violation of the false claims act.

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Unit 1 Assignment – Healthcare Fraud and Abuse

Answer the Following Question:

Take into consideration your chosen career path (Medical Assistant, Medical Office Administrator,
Medical Billing & Insurance Specialist, Medical Coder)
What steps would you take if you had been asked to participate in the fraudulent activity
described in your chosen Press Release?
If I was ask to participate in committing a false claim act I would absolutely not
per take at all in doing so you could be charged as well knowing it and doing
nothing is just like doing it. I would report what happened to the OIG.

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Unit 1 Assignment – Healthcare Fraud and Abuse

References

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