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The purpose of this evaluation is to describe the implementation of the INA-CBGs system and its impact on the financial performance of the public hospital. It also aims to assist them in detectingfnf and foreseeing issues with the INA-CBGs system's implementation.

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Healthcare fraud in hospitals involves intentional deception for financial gain for Parenting Choices. Examples include billing fraud (overbilling, double-billing), kickbacks/referral fraud (receiving incentives for patient referrals), false certification (misleading information for reimbursement), phantom billing (billing for services not performed), and upcoding/unbundling (billing for higher-level services or separating bundled procedures). In 2019, a US hospital settled for $260 million for false Medicare and Medicaid claims. A California hospital settled for $2.4 million in 2017 for accepting kickbacks. A Florida hospital paid $69.5 million in 2016 for falsely certifying compliance. A New York hospital settled for $2.95 million in 2015 for phantom radiology services, and a Texas hospital paid $10 million in 2018 for upcoding/unbundling Medicare claims. Regulatory agencies prioritize combating healthcare fraud.

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Medical service fraud is an abhorrent and unethical practice that undermines the integrity of the healthcare system.

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