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Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : Crime
Languages : en
Pages : 316
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Book Description
Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : Crime
Languages : en
Pages : 316
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Book Description
Author: John Bear
Publisher: Prometheus Books
ISBN: 1616145080
Category : Education
Languages : en
Pages : 430
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Book Description
When the first edition of Degree Mills was published, fake universities and counterfeit degrees were already a significant problem. Fueled by the Internet, this scam continues to grow—now more than half of all people claiming a new PhD in fact have a fake degree. In this updated edition, experts Allen Ezell and John Bear go beyond exposing these fraudulent practices to provide detailed recommendations—for government agencies, educational institutions, and individuals—on what can be done to rid us of them. This eye-opening and definitive guide shows how degree mills operate and how to check the validity of anyone’s degree—an indispensable reference book.
Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : False certification
Languages : en
Pages : 310
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Book Description
Author: Terry L. Leap
Publisher: Cornell University Press
ISBN: 0801461286
Category : Medical
Languages : en
Pages : 253
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Book Description
U.S. health care is a $2.5 trillion system that accounts for more than 17 percent of the nation’s GDP. It is also highly susceptible to fraud. Estimates vary, but some observers believe that as much as 10 percent of all medical billing involves some type of fraud. In 2009, New York’s Medicaid fraud office recovered $283 million and obtained 148 criminal convictions. In July 2010, the U.S. Justice Department charged nearly 100 patients, doctors, and health care executives in five states of bilking the Medicare system out of more than $251 million through false claims for services that were medically unnecessary or never provided. These cases only hint at the scope of the problem. In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap takes on medical fraud and its economic, psychological, and social costs. Illustrated throughout with dozens of specific and often fascinating cases, this book covers a wide variety of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud, as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering). After assessing the effectiveness of the federal laws designed to fight health care fraud and abuse—the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws—Leap suggests a number of ways that health care providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control, thereby reducing the overall cost of medical care in America.
Author: Brad McKay
Publisher:
ISBN: 9780369366672
Category : Common fallacies
Languages : en
Pages : 0
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Book Description
We all want to be healthy, live longer and avoid cancer, but too many of us are being scammed by sciencey-sounding crooks and nonsense marketing. Dr Brad McKay, GP and experienced Australian science communicator, has watched how misinformation and 'alternative facts' have come to permeate every facet of our lives, causing many of us to turn away from academic expertise and instead look to social media influencers and dodgy websites to guide our health choices. Fake Medicine looks at the danger of Wellness Warriors, conspiracy theories and vaccine deniers, supplements and fad diets, alternative practitioners and the power of positive thinking, and interrogates the marketing that leads consumers toward dubious products and practices. In the wash of celebrity influencers and miracle cures, this is the essential book to debunk the faux-science and scam marketing of the modern health landscape.
Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : Degrees, Academic
Languages : en
Pages : 208
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Book Description
Author: Paul Jesilow
Publisher: Univ of California Press
ISBN: 0520911830
Category : Medical
Languages : en
Pages : 366
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Book Description
In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing. How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment. The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity. Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.
Author: Malcolm K Sparrow
Publisher: Hachette UK
ISBN: 0465010741
Category : Political Science
Languages : en
Pages : 304
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Book Description
Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
Author:
Publisher:
ISBN:
Category : Degrees, Academic
Languages : en
Pages : 20
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Author: Saul William Seidman
Publisher: Universal-Publishers
ISBN: 159942956X
Category : Business & Economics
Languages : en
Pages : 200
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Book Description
Fraud is the result of government and insurance company control of health care. The growth of bureaucracy is a precursor to incompetence and soaring costs of medical care. A lack of clinical diagnosis and a dependence on expensive testing has increased costs while decreasing the doctor's competence. The FBI and the attorneys general of all states are dealing with exploding health care fraud. The result is a trillion dollars in waste and deception. Trillion Dollar Scam details the origin of this fraud and waste, and offers solutions to fixing the broken U.S. health care system.
