By Terry L. Leap
U.S. health and wellbeing care is a $2.5 trillion process that debts for greater than 17 percentage of the nation's GDP. it's also hugely vulnerable to fraud. Estimates fluctuate, yet a few observers think that up to 10 percentage of all scientific billing consists of a few kind of fraud. In 2009, New York's Medicaid fraud workplace recovered $283 million and bought 148 legal convictions. In July 2010, the U.S. Justice division charged approximately a hundred sufferers, medical professionals, and well-being care executives in 5 states of bilking the Medicare method out of greater than $251 million via fake claims for companies that have been medically pointless or by no means supplied. those circumstances in basic terms trace on the scope of the problem.
In Phantom Billing, pretend Prescriptions, and the excessive expense of Medicine, Terry L. bounce takes on clinical fraud and its fiscal, mental, and social bills. Illustrated all through with dozens of particular and infrequently attention-grabbing instances, this ebook covers a large choice of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, assurance scams, short-pilling, off-label advertising and marketing of prescribed drugs, and rebate fraud, in addition to legal acts that let this fraud (mail and twine fraud, conspiracy, and cash laundering).
After assessing the effectiveness of the federal legislation designed to struggle overall healthiness care fraud and abuse-the antikickback statute, the Stark legislations, the fake Claims Act, HIPAA, and the nutrition and drug laws-Leap indicates a couple of ways in which overall healthiness care companies, shoppers, insurers, and federal and nation officers can carry well-being care fraud and abuse less than keep watch over, thereby lowering the final rate of remedy in America.
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Extra info for Phantom Billing, Fake Prescriptions, and the High Cost of Medicine: Health Care Fraud and What to Do about It (The Culture and Politics of Health Care Work)
Phantom Billing, Fake Prescriptions, and the High Cost of Medicine: Health Care Fraud and What to Do about It (The Culture and Politics of Health Care Work) by Terry L. Leap
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