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ABUSIVE TREATMENTS OR MEDICAL SERVICES
By Dr. David Edward Marcinko MBA CMP®
SPONSOR: http://www.CertifiedMedicalPlanner.org
According to the Dictionary of Health Economics and Finance, healthcare abuse is the activity where someone overuses or misuses services. And; the Center for Medicare and Medicaid Services [CMS] states that: “although some of the practices may be initially considered to be abusive, rather than fraudulent activities, they may evolve into fraud.”
CITE: https://www.r2library.com/Resource/Title/0826102549
In the case of healthcare abuse, this may occur when a physician sees the patient for treatment more times than deemed medically appropriate. If there are reported issues or actions from other sources, such as the National Practitioner Data Bank [NPDB] or a medical board, a health insurance program can take that opportunity to review healthcare providers’ activities.
ASSESSMENT: Most insurance or managed care participation agreements allow for this type of scrutiny.
QUERY: But, what if the patient, or care-giver, is the culprit?
MUNCHAUSEN SYNDROME BY PROXY: https://www.webmd.com/mental-health/munchausen-by-proxy
YOUR THOUGHTS ARE APPRECIATED
ORDER TEXTBOOK: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989
INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/
THANK YOU
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Filed under: Health Insurance, Recommended Books, Risk Management | Tagged: ABUSIVE HEALTH CARE SERVICES, ABUSIVE MEDICAL TREATMENT, David Edward Marcinko, MUNCHAUSEN SYNDROME, MUNCHAUSEN SYNDROME PROXY |
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