ABO/Rh Testing, Antibody Screening, and Biometric Technology as Tools to Combat Insurance Fraud: An Example and Discussion

Abstract

In 2012, more than 47 million Americans lacked health insurance1; this is a serious problem because everyone will need access to healthcare at certain times in their lives. The main reason for lack of health insurance before the passing of the Patient Protection and Affordable Care Act (PPACA) in the United States has been reported to be affordability.1 In March 2010, the Patient Protection and Affordable Care Act was signed into law. The PPACA was especially enacted to reduce the number of uninsured Americans by providing affordable, quality health insurance and to curb healthcare spending.2 Reducing the number of uninsured is to be accomplished by expanding public (Medicaid) and private insurance as well as making health insurance more affordable by providing subsidies to eligible applicants, instituting mandates, providing tax credits and insurance exchanges.2 The Medicaid expansion clause is optional for states and as a result, some states choose not to expand eligibility. The PPACA law has a provision for a health insurance market place, which has allowed uninsured individuals, along with those who purchased their own insurance to compare and buy health insurance at affordable premiums with the help of subsidies.3 The law calls for insurance companies to accept all applicants regardless of any pre-existing conditions or gender and eliminates annual or lifetime caps on healthcare benefits. In addition, Members’ coverage cannot be terminated due to illness. All these provisions allow for addition as well as retention of individuals with health insurance coverage.2 Individuals living in states that have expanded Medicaid eligibility and have incomes below the poverty level are more likely to obtain health insurance coverage through Medicaid.3 Even with the relative affordability of health insurance, some individuals will not still purchase health insurance for various reasons. States that do not …