HEALTHCARE FRAUD AND ABUSE

Healthcare Fraud and Abuse



Healthcare Fraud and Abuse

Annotated Bibliography

Kesselheim, S., Studdert, M. and Mello, M. (2010), “Whistle-Blowers' Experiences in Fraud Litigation against Pharmaceutical Companies”, Massachusetts Medical Society, pp. 1832-9

Healthcare and wellness of an individual is his or her basic right. Everyone, no matter to which culture, class and race he or she belongs to deserve a proper system that provide healthcare benefits. U.S. healthcare industry is huge, and is the industry that constitutes 15% of the overall economy of U.S. and is considered as one of the largest and best healthcare industry all over the world. When any industry operates on such a huge level and involves more of the private entities rather than the government, it is likely to get affected from malpractices of different sorts of frauds and abuses. This paper discusses fraud and abuses in U.S healthcare industry its impact on overall industry and how to deal with this issue.

Straughair, C. (2011), “Safeguarding vulnerable adults: the role of the registered nurse”, Nursing Standard, Vol. 25, pp. 49-56.

This article discusses vulnerable patient groups who may be at risk of being abused by family members, healthcare professionals or practitioners. Different types of abuse, including institutional abuse, and the associated signs and symptoms are described in this study. In this study, a vulnerable adult has been defined as a person who is 18 years of age or over and requires a degree of care as a result of age, illness, mental status or physical disability. The selected sample all adults have the potential to become vulnerable at some stage in their lives because of the ageing process or illness (for example, stroke or acute or chronic physical and mental illnesses), which cause them to become more dependent on others for their care needs.

However, some people may be at particular risk as a result of their condition and social circumstances (DH and Home Office 2000, Safeguarding Vulnerable Groups Act 2006). Therefore, all nurses need to be aware of the factors that may contribute to an individual's vulnerability. The article highlights that registered nurses working with adults need to be aware of at-risk groups and understand how to implement measures to protect and safeguard vulnerable individuals at their place of work. The study concluded that, nurses have a key role in the protection of vulnerable adults. Abuse can occur in a range of environments, including NHS and voluntary organizations, private care homes and patients' personal residences. Nurses need to be aware of adults in their care who could be vulnerable to and at risk of abuse. To safeguard the vulnerable adult, nurses need to understand the different types of adult abuse and the associated signs and symptoms, ensuring that any abuses reported appropriately.

Boumil, S., Narianib, A., Boumilc, M., and Bermanb, H. (2010), “Whistle blowing in the pharmaceutical industry in the United States, England, Canada, and Australia”, Journal of Public Health Policy, Vol. 31, pp. 17-29.

Abuse and fraud in the expenditure of public wealth plague governments around the ...