Detecting Medicare abuse.
نویسندگان
چکیده
This paper identifies which types of patients and hospitals have abusive Medicare billings that are responsive to law enforcement. For a 20% random sample of elderly Medicare beneficiaries hospitalized from 1994 to 1998 with one or more of six illnesses that are prone to abuse, we obtain longitudinal claims data linked with social security death records, hospital characteristics, and state/year-level anti-fraud enforcement efforts. We show that increased enforcement leads certain types of types of patients and hospitals to have lower billings, without adverse consequences for patients' health outcomes.
منابع مشابه
Self disclosure. How to manage the risk of Medicare fraud and abuse.
When you discover an incident of noncompliance with Medicare/Medicaid regulations, step forward and notify the authorities before the government or a whistleblower takes the problem out of your hands.
متن کاملMedicare and State health care programs: fraud and abuse; OIG anti-kickback provisions--HHS. Final rule.
This final rule implements section 14 of Public Law 100-93, the Medicare and Medicaid Patient and Program Protection Act of 1987, by specifying various payment practices which, although potentially capable of inducing referrals of business under Medicare or a State health care program, will be protected from criminal prosecution or civil sanctions under the anti-kickback provisions of the statute.
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عنوان ژورنال:
- Journal of health economics
دوره 24 1 شماره
صفحات -
تاریخ انتشار 2005