Preventing Fraud, Waste, and abuse Simulation Essay

Preventing Fraud, Waste, and abuse Simulation - Essay Example The outcome of a simulation is difficult to determine especially in terms of benefits and the cost since most of the ocassio0ns that call for its applications are very challenging and may involve a long-term use. A range of motivating forces and execution machinery can be expected to push simulation forward, together with professional societies, legal responsibility insurers, medical care payers, and in due course the general public. The prospects of simulation in healthcare fully rely on the dedication and resourcefulness of the healthcare simulation community to see that enhanced patient well-being by means of this instrument becomes a reality. With the increased federal and state government expenditure on health care each year, the concerns of fraud and abuse also increase. A lot of money has been lost to fraud and abuse allegations with CMS estimating about 15 to 25 US dollars per year in Medicaid fraud and close to 1.1 US dollars were recovered in 2005 in false health care claims. It is with this in mind that all pharmacies have been called upon to safeguard any possible abuse, fraud, and waste. It is the obligation of any company to protect itself against fraud, abuse, and waste and try to eliminate it completely. Several companies have put in place some policies and procedures that are used to fight fraud, abuse, and waste. It’s the obligation of every employee of an organization to put a stop to fraud, abuse, and waste, failure to do so may result in the following; For individual involvement in either of the scandals, the repercussions include disciplinary actions that may even call for job termination. It is, therefore, necessary that everybody in the company is conversant with the knowledge of fraud which include how to identify fraud and abuse, prevention, and reporting of abuse and fraud.

Continental Airlines, Inc and McDonnell Douglas Corporation Article

Continental Airlines, Inc and McDonnell Douglas Corporation - Article Example The case was submitted to the jury. On the basis of Continental’s theories of fraud, it was taken as evidence by the jury. Supreme Court ruling Hauter v. Zogarts (1975), it was held that the promises of safety were not statements of â€Å"opinion† or just â€Å"puffing† but representations of facts. Thus, the four representations of the brochure were not opinions but statements of facts. Further, the statements made by McDonnell Douglas were material. There is substantial evidence that Douglass statements regarding Landing Gear Breakaway were material and that Continental rightly trusted them in deciding to clinch the DC-10 deal. The court viewed the evidence in the light most well disposed to the judgment, taking all reasonable inferences and not taking conflicting evidence. There was evidence as quoted in section F that the landing gear was designed to break away from the wing without rupturing the wing fuel tank, which was material and rightfully trusted by Co ntinental. It is further proved by Douglass argument that Continental must prove that a clean landing gear breakaway was a condition of its decision to purchase the DC-10, rather than the L-1011, proving that Continental trusted the statements of McDonnell Douglas. California law is quite clear about whether it constitutes fraud making reckless false representations without any consideration to the truth. It states that â€Å"[s]ince direct proof of fraudulent intent is often impossible, the intent may be established by [in]ference [216 Cal.App.3d 412] from acts of the parties.' [Citation]† Another established law is that if evidence is applicable for any purpose it must be taken into consideration, even if it may not be proper for another purpose.   California law is quite clear