License to Steal
Subtitle: How Fraud Bleeds America's Health Care System
Edition: Updated edition
Publisher: Westview Press
Published: July 1, 2000
Language: eng
Format: Hardcover
Number of pages: 304
ISBN-13: 9780813368108
Subjects: Criminal investigation & detection; Health systems & services; United States; Medical; Criminology (Specific Aspects); Financial Management In Health Care; Medical / Nursing; Practice Management & Reimbursement; Medicare fraud; Health Care Delivery; Health Policy; Medical / Health Care Delivery; Medical-Health Policy; Corrupt practices; Medicaid fraud; Medical care
First sentence: What makes the health care system in general, and claims-payment systems in particular, such attractive targets for fraud?
Description: Fraud and abuse bleeds more than 100 billion dollars each year out of the U.S. health system. This detailed examination shows the problem is worse than almost anyone knows, mostly invisible, and still far from controlled. Sparrow reveals that current control systems fail by presenting fraud perpetrators with a safe, easy-to-hit target: fully automated check-printing systems, which only require thieves to bill "correctly" regardless of whether or not any medical service is provided. This target attracts an extraordinary range of criminal entrepreneurs, 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, even major hospital chains. Sparrow's research examines the much-misunderstood effects of managed care on the problem, the government's recent attempts to grapple with fraud, and the campaign by various provider associations to undermine those efforts.