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$100 Billion Wasted Each Year on Healthcare Fraud
Augusta, MI 49012
March 23 2006
Healthcare Compliance Expert Available to Comment On Healthcare Fraud
The most surprising reason for your healthcare cost increases? Fraud.
According to the Government Accounting Office, over $100 billion is
wasted each year because of fraud in the healthcare industry.
In response to the increase in healthcare fraud and inefficiency,
President Bush recently signed the Deficit Reduction Act of 2005 that
“mandates the establishment of compliance programs” in every healthcare
entity that receives at least $5 million in Medicaid payments per year.
“This is a win-win for everyone involved,” says Pati Trites, compliance
expert and CEO of Healthcare Compliance Resources
(www.ComplianceResources.com).
o Taxpayers win. Taxpayers will save money because less public money will be needed for fighting fraud and abuse.
o Consumers win. Healthcare costs will decrease for consumers because
fraud, waste, and inefficiency will be reduced. Billing and
reimbursement procedures will be streamlined which will also save
consumers time and money.
o Healthcare providers win. Healthcare providers will become more
compliant thus increasing their efficiency and effectiveness and
reducing their risk of negligence or error. Patient satisfaction will
increase, turnover will decrease, and more money will be made in the
long run.
o Patients win. Patients will receive better care from compliant providers.
The new law demands that all employees, agents and contractors must
undergo fraud and abuse training programs beginning January 1, 2007.
The law also requires written training materials to include the
entity’s policies and procedures for detecting and preventing fraud,
waste and abuse. Furthermore, employee handbooks provided by the entity
now must contain a discussion of these laws, and the rights and
protections afforded to employees as whistleblowers.
Although the new law will benefit everyone in the end, it does create
some immediate challenges. Healthcare entities that were getting by
without a compliance program must spend time and money implementing
these programs. States must regulate and monitor the entities to ensure
they are abiding by the law. Patients will need to get acclimated with
new procedures and healthcare providers will likely have to attend
trainings or explanatory seminars.
These challenges can be eased by hiring a compliance expert like Pati
Trites, who offers compliance programs and compliance training
(www.ComplianceResources.com). “Our mission has always been to educate
the healthcare industry on the laws that they have to follow and how to
do it in a cost-effective manner. We like to see our clients not having
to worry about audits, investigations, fines and penalties. Compliance
programs create a much better working environment for the entire staff,
creating better morale, better staff to patient interaction, less
turnover of employees, more efficient systems and in the end, more
money in the provider’s pocket at the end of the day,” says Trites.
ABOUT PATRICIA TRITES:
The Chief Executive Officer of Healthcare Compliance Resources,
Patricia Trites was the first woman in the country to receive dual CHCC
and CHCO certification. She is the author of the Healthcare
Organization and Medical Office Compliance Program Guide, the only
guide of its kind, rated 4 out of 5 stars by The Journal of Healthcare
Compliance.
Patricia has a Master of Public Administration in Healthcare and a
Bachelor of Business Administration from Western Michigan University.
She is currently working on her PhD in Business Management. She has
worked as a college instructor in healthcare administration and
accounting. An in-demand speaker and writer for national healthcare
industry conventions and publications, she also conducts client
assessments throughout the country and offers compliance guidance in
the areas of billing and reimbursement, HIPAA, OSHA, CLIA, and
employment requirements and regulation.
Patricia Trites (pati@complianceresources.com) CEO Healthcare Compliance Resources 507 W. Jefferson
Augusta, MI 49012 Phone : 269-731-2561 Fax : 269-731-4346
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