In 2016, the largest health care fraud ever committed was revealed to the public. According to Mangan (2016, July 23), “three Florida residents have been charged in an alleged Medicare fraud and money laundering scheme that netted participants a whopping $1 billion since 2009” (pp. 1). Such a fallout had the potential of rallying the public into a massive discontentment with the security of the Medicare system specifically and the whole U.S health care system in general. Moreover, it would probably cause the public to question the work of the U.S. Justice Department heavily, seeing as it has overlooked such a massive fraud for more than seven years.
It is safe to say that among all of the American states, Florida has the largest history of medical care fraud. Mangan (2016, July 23) supplies that “south Florida is a hot spot for health-care billing fraud schemes that target the huge federal Medicare program, and the giant joint federal-state Medicaid program” (pp. 9). Although in the field of assisted living specifically, it is not a common occurrence, there are still many fraud schemes associated with the health care sector in general. Perez and Wing (2018) state that “Fraud Control Units conduct investigations that recover almost $1.8 billion in inappropriate Medicaid spending, returning $7 for every $1 spent” (p. 1). Thus, it can be concluded that health care remains one of the most vulnerable sectors in regards to scam cases.
As the number of older adults in need of assisted living grows, so grow the challenges associated with it. Ensuring that the patients receive quality care despite the high numbers of them, could help to attract more professional healthcare workers into the field. Additionally, the use of technology in the assisted living health care system could also improve the situation. Bozan and Berger (2019) state that “ambient AL technology currently has the ability to anticipate and respond to the heterogeneous nature of the needs of the elderly and their caretakers” (p. 4308).
When selecting long-term care services, I would recommend the families to ask the following questions. Is it a professional facility with a legal, active license? Does the staff have all of the required competencies? What are the reviews from other patients who already had been in their care? Such questions would help ensure the quality of the care the service provides.
References
Bozan, K., & Berger, A. (2019). Revisiting the technology challenges and proposing enhancements in ambient assisted living for the elderly. Proceedings of the 52nd Hawaii International Conference on System Sciences. Web.
Mangan, D. (2016). $1 billion alleged Medicare fraud, and money laundering scheme leads to Florida arrests. CNBC. Web.
Perez, V., & Wing, C. (2018). Should we do more to police Medicaid fraud? Evidence on intended and unintended consequences of expanded enforcement. SSRN Electronic Journal. Web.