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Preventing fraud and abuse fallout.

C M Mayer1

  • 1Coopers & Lybrand, Arlington, VA, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|March 9, 1995
PubMed
Summary
This summary is machine-generated.

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Healthcare organizations can mitigate fraud, waste, and abuse risks by adopting ethics-awareness and compliance programs. Learning from the defense industry can improve financial and public relations outcomes.

Area of Science:

  • Healthcare Management
  • Business Ethics
  • Public Policy

Background:

  • Increasing scrutiny of healthcare costs necessitates proactive measures against fraud, waste, and abuse.
  • The defense industry offers a precedent for addressing similar allegations effectively.

Purpose of the Study:

  • To explore the applicability of defense industry strategies for combating healthcare fraud, waste, and abuse.
  • To highlight the role of ethics and compliance programs in mitigating financial and reputational risks.

Main Methods:

  • Comparative analysis of industry approaches to fraud, waste, and abuse.
  • Review of ethics-awareness and compliance program frameworks.
  • Examination of risk mitigation strategies.

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Main Results:

  • Ethics-awareness programs can foster a culture of integrity.
  • Robust compliance programs are crucial for preventing violations.
  • Proactive training reduces the likelihood of financial penalties and negative publicity.

Conclusions:

  • Healthcare entities can benefit from implementing defense industry-tested ethics and compliance strategies.
  • These programs are essential for managing costs and maintaining public trust.
  • Adopting such measures can lead to significant improvements in operational integrity and financial health.