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The Affordable Care Act aims to enhance our medical system in different ways. Some of them are reinforcing Medicare, lowering healthcare costs, and extending privacy rights. The government accomplishes these objectives in part by enforcing severer regulations. Thus, compliance methods are essential for all health care professionals, given the increased awareness of discipline, punishment, and recovery. Consequently, at least one of the main intentions in health care reform should be reducing waste, fraud, and abuse in this act.
Arguably, everybody in the United States is significantly influenced by healthcare fraud, waste, and abuse. Therefore, people and health care professionals should understand how to detect and help to prevent it. The ACA” produced the most significant gains in insurance coverage in nearly fifty years” (Sommers et al., 2017, p. 1120). Unfortunately, fraud occurs when someone deliberately lies to a health insurance provider to obtain money. When someone recklessly uses health care services, it is a waste. Furthermore, abuse issues while standard medicine practices are not followed, resulting in expenses and treatments. It does influence patients; thus, they should be able to spot it, while the authorities should prevent it.
Each health care organization should initiate the corresponding measures to comply with the ACA. The authorities have to make a distinct pattern such as informing all patients about possible schemes and promote it as well, because” the impact of healthcare fraud is significant and wide-reaching” (Stowell et al., 2018, p. 1041). As an example, humans should detect when doctors execute a procedure that is not included in their health plan or be aware of professionals who corrupt the system by giving multiple prescriptions for identical medicine. Additionally, patients are sometimes provided brand-named pills when a lower-cost nonexclusive alternative operates the same. Those shenanigans should be counteracted because the ACA has enormous influence in the US” addressing public health, including creating a public health council and a $15 billion public health fund” (Campbell & Shore-Sheppard, 2020, p. 9). The government and healthcare organizations should at least teach people how to avoid such situations.
To counteract these shenanigans, the government and healthcare organizations should partially teach people how to avoid such circumstances. Undoubtedly, it affects you when health care providers or anybody else participates in healthcare fraud, waste, or abuse. Consequently, for individuals, it may lead to substantial monetary losses, compromise their safety, and increase their health risk just because some untrustworthy professionals try to take unnecessary benefits.
References
Campbell, A. L., & Shore-Sheppard, L. (2020). The social, political, and economic effects of the Affordable Care Act: Introduction to the issue. The Russell sage foundation journal of the social sciences, 6(2), 1-40.
Sommers, B. D., Maylone, B., Blendon, R. J., Orav, E. J., & Epstein, A. M. (2017). Three-year impacts of the Affordable Care Act: improved medical care and health among low-income adults.Health affairs, 36(6), 1119-1128.
Stowell, N. F., Schmidt, M., & Wadlinger, N. (2018). Healthcare fraud under the microscope: improving its prevention. Journal of financial crime, 25(4), 1039-1061.
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