Frauds in Healthcare Industry Assignment
Added on 2020-04-01
7 Pages1583 Words106 Views
Qwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxc Frauds in healthcare industry
Frauds in healthcare industry 2Frauds in healthcare industryIntroductionIncreased number of frauds in the healthcare industry has become a major concern now days. Inthe year 2012, a total of $2.28 trillion was spent on health care industry to take measures againstthese frauds but it had no impact on the number of frauds.as per National Health Care antifraudAssociation (NHCAA) estimates of financial losses due to these frauds are in tens of billiondollars. Majority of the frauds are done by the internal staffs of the hospital that are well awareof the loopholes of the processes of which they make use[ CITATION Cha13 \l 1033 ]. They are verywell aware that where the company lacks behind be it a technological issue or managerial issue.In many of the cases it has been observed that whenever any exception id done for any employeeit results in a fraud most of the times like in this case study, when the HR department took anexception and ignored the polies they had to bear the losses because the employee which theykept was the son of one of the senior staff and as per polies this is not allowed[ CITATION Ali05 \l1033 ]. Critical analysisThere are three reasons in the case study due to which the fraud happened
Frauds in healthcare industry 3Technical- HH is a large hospital in San Francisco which consists of approx. 340 patient bedsand 420 physicians and is also affiliated with the prominent university and medical school. It wasfounded in the year 1912 and in the year 1990 hospital started using mid-range informationsystems namely AS/400 and TANDEM hardware along with client/server technology and sincethen it has undergone minor upgrades and customization, this is one of the loop holes which canlead to fraud. When we are not moving with the market condition accordingly then there arechances of fraudsters to mold the obsolete software’s as per there need[ CITATION Cha13 \l 1033 ].In this case study it was the responsibility of Tracy downs to take care of all the files of vendorsand delete the obsolete ones but she was not doing it properly and in fact when Matt Harris waspromoted as permanent employee still his vendor file was not deleted due to which he was ableto input the fraud data of vendors under his own vendor account. And when his boss was out forvacations Matt was given the access to main safe where pre signed checks were lying and usingthose he forged checks[ CITATION Wil09 \l 1033 ]. Organizational- when we make organizational policies then they should be strictly followedbecause they are made keeping in mind the benefit of the welfare of the organization. In this casewhen there is a policy that you cannot hire a person who belongs to the blood relative of theexisting staff then why Matt Harris was kept on the job and if kept then why the backgroundverification was not done[ CITATION Mal14 \l 1033 ]. Tracy Down the accounts payable managercould have prevented this fraud from happening if he doesn’t override the policies made. In spiteof being warned by internal auditors, she doesn’t bother to listen to anyone and promoted him asa permanent employee.
End of preview
Want to access all the pages? Upload your documents or become a member.
Related Documents
Information Governance and Fraud Prevention in Healthcare Organizationslg...
|7
|2187
|313