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Field of Study
Medicine
Subject
Health Care Delivery, Criminal Law / General, Health Policy
ISBN
9780801449796
Subject Area
Law, Medical
Publication Name
Phantom Billing, Fake Prescriptions, and the High Cost of Medicine : Health Care Fraud and What to Do about It
Publisher
Cornell University Press
Item Length
9.2 in
Publication Year
2011
Series
The Culture and Politics of Health Care Work Ser.
Type
Textbook
Format
Hardcover
Language
English
Item Height
0.9 in
Author
Terry L. Leap
Item Weight
32 Oz
Item Width
6.1 in
Number of Pages
256 Pages

關於產品

Product Identifiers

Publisher
Cornell University Press
ISBN-10
0801449790
ISBN-13
9780801449796
eBay Product ID (ePID)
99624006

Product Key Features

Number of Pages
256 Pages
Language
English
Publication Name
Phantom Billing, Fake Prescriptions, and the High Cost of Medicine : Health Care Fraud and What to Do about It
Subject
Health Care Delivery, Criminal Law / General, Health Policy
Publication Year
2011
Type
Textbook
Author
Terry L. Leap
Subject Area
Law, Medical
Series
The Culture and Politics of Health Care Work Ser.
Format
Hardcover

Dimensions

Item Height
0.9 in
Item Weight
32 Oz
Item Length
9.2 in
Item Width
6.1 in

Additional Product Features

Intended Audience
Trade
LCCN
2010-041491
Dewey Edition
22
Reviews
"Concerning health care fraud and abuse, Terry L. Leap thoroughly describes the sources and magnitude of the problem, which may approximate $300 billion annually in the United States. Given the government's growing appetite for revenue, all health care providers are urged to read this book and implement its recommendations before being snared by the government."--Michael J. Stahl, William B. Stokely Professor of Business and Director of the Physician Executive MBA Program, University of Tennessee, "Concerning health care fraud and abuse, Terry L. Leap thoroughly describes the sources and magnitude of the problem, which may approximate $300 billion annually in the United States. Given the government's growing appetite for revenue, all health care providers are urged to read this book and implement its recommendations before being snared by the government."-Michael J. Stahl, William B. Stokely Professor of Business and Director of the Physician Executive MBA Program, University of Tennessee, "One doesn't often find superb investigative reporting in the academy or from a university press. Terry L. Leap provides a remarkable exception in his devastating account of rampant fraud in the American healthcare system. One can only hope that every legislator, Medicare administrator, and health executive in the country will read and heed this well-documented, clearly written report."--Mark Dowie, Host and Executive Producer, Talking Point Radio, "One doesn't often find superb investigative reporting in the academy or from a university press. Terry L. Leap provides a remarkable exception in his devastating account of rampant fraud in the American healthcare system. One can only hope that every legislator, Medicare administrator, and health executive in the country will read and heed this well-documented, clearly written report."-Mark Dowie, Host and Executive Producer, Talking Point Radio, One doesn't often find superb investigative reporting in the academy or from a university press. Terry L. Leap provides a remarkable exception in his devastating account of rampant fraud in the American healthcare system. One can only hope that every legislator, Medicare administrator, and health executive in the country will read and heed this well-documented, clearly written report.
Grade From
College Graduate Student
Illustrated
Yes
Dewey Decimal
364.16/3
Table Of Content
Introduction: The Big Picture 1. Health Care Fraud and Its Facilitating Crimes 2. The Major Health Care Fraud Laws 3. Fraud in Fee-for-Service and Managed Care: Different Sides of the Same Coin 4. Fraud at Major Hospitals: Profits at Any Cost, Part 1 5. Fraud in the Pharmaceutical, Medical Equipment, and Supply Industries: Profits at Any Cost, Part 2 6. Fighting Health Care Fraud and Abuse ConclusionAppendix: A Note on the Major U.S. Public Insurance Programs Notes References Index
Synopsis
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., 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., 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.
LC Classification Number
RA395.A3L4125 2011
Copyright Date
2011
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