Medical Science is still in its development stages as cures for diseases that were incurable are being developed. Such an example is of cancer, Hepatitis B and etc. These diseases were incurable some time ago but the advancement in medical sciences has enabled doctors to cure such diseases. Treatment for these diseases is not only available but is also done at cheap rates that are affordable, but still affordability has been a problem. Medical Science has experienced two major problems in the last decade. Number one is the affordability of treatment and medicines for people and secondly the fraud and abuse of medicines which has become very common around the world (Kelman amp. Straker, 1999). In this paper we will discuss how the federal government of US has controlled the cost associated with the Medicaid program and how it has helped reduce the Medicaid fraud and abuse.
Good health is significant to everyone. If a person can’t pay for medical care right now, Medicaid can make it probable for him or her to get the care that is needed so that the person can get healthy and stay fit. Medicaid is obtainable only to certain low-income individuals and families who fit into an eligibility cluster that is recognized by federal and state law. Medicaid does not disburse money to a person instead, it sends payments straight to the person’s health care provider (Heiser, 2008). Depending on the state’s rules, a person may also be asked to compensate a small division of the charge for a few medical services. Medicaid is a state administered plan and each state sets its individual guidelines regarding eligibility and services. Many groups of people are roofed by Medicaid, even within these groups, though, definite requirements must be met. These may comprise of age, pregnancy, disability, blindness, or old age, income and resources and if a person is a U.S. citizen or a lawfully admitted immigrant. The regulations for counting the income and resources differ from state to state and from group to group. There are particular rules for those who reside in nursing homes and for disabled children living at home (Commerce Clearing House, 2007). A child may be entitled for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if his or her parents are not. Eligibility for children is based on the child’s status, not the parent’s. Also, if someone else’s child lives with a person, the child may be qualified even if that person is not because the earnings and resources will not add up for the child.
Fraud and Abuse
The Centers for Medicare amp. Medicaid Services CMS is dedicated to fighting fraud and abuse, which redirect dollars that could or else be spent to preserve the health and welfare of Medicaid customers. To fortify its obligation, CMS has implemented a Medicaid veracity module. This is in reply to the requirements of the Deficit Reduction Act DRA of 2005, finalized on February 8, 2006 by the President, in which Congress proposed CMS to establish the Medicaid Integrity Program MIP. In doing so, it spectacularly augmented the resources accessible to CMS to fight fraud, misuse and exploitation in the Medicaid program. The DRA says that a five-year Comprehensive Medicaid Integrity Plan CMIP be printed to guide MIP growth and functions. This CMIP specially discusses statutory necessities, program