Legislature Journal of Nursing

Legislature Ought to Increase Rewards up to 10 Million Dollars to Whistleblowers who Combat Medicare Fraud and Abuse

Legislature Ought to Increase Rewards up to 10 Million Dollars to Whistleblowers who Combat Medicare Fraud and Abuse

Tags: Legislature Medicare Medicare Fraud Whistleblowers

The legislature ought to enact this proposed rule to increase rewards to combat Medicare fraud and abuse, in an attempt to increase more whistleblowers to come forward. Empirical research shows that this proposed rule has had the following good effects to increase rewards up to 10 million dollars to whistleblowers for reporting Medicare fraud and abuse and should therefore be seriously enhanced by legislature.  The role of legislature in combating Medicare fraud and abuse to increase the amount of the rewards paid to whistleblowers whose tips about suspected fraud and abuse lead to the successful recovery of funds up to 10 million dollars. The intent of this proposed rule is to provide reward to whistleblowers in case of actual fraud or reckless disregard in the submission of claims.

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Closing the Donut Hole: Who Will Pay?

Closing the Donut Hole: Who Will Pay?

Tags: donut hole Health Care Reform healthcare system Legislature Medicare Medicare Supplement prescriptions

The dark black hole in the Medicare Part-D prescription plan called the donut hole is finding the light, or is it? Health care reform has promised to close the donut hole for Medicare recipients completely by the year 2020 (Gionfriddo, 2010). The Consumer Report on Health (2012) confirms medication costs continue to rise with no end in sight. Who will pay the gap between what is currently covered and the predicted added coverage with Health Care Reform? According to the Center for Medicare and Medicaid Services (CMS, 2011) the Medicare trust fund is currently running in a deficit. Reducing the burden of our Medicare population, with associated out-of-pocket expenses for prescription drugs, cannot be achieved by a system already running in a deficit. As we start to unravel the mystery behind closing the donut hole, can we identify who will pay?

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