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Fraudulent Medical Degrees

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

Book Description

Fraudulent Medical Degrees

Book Description

Fraudulent Medical Degrees

Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : Crime
Languages : en
Pages : 300

Book Description

License To Steal

Author: Malcolm K Sparrow
Publisher: Basic Books
ISBN: 0465010741
Category : Political Science
Languages : en
Pages : 306

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.

Degree Mills

Author: John Bear
Publisher: Prometheus Books
ISBN: 1616145080
Category : Education
Languages : en
Pages : 430

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.

Fraudulent Credentials

Author: United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care
Publisher:
ISBN:
Category : Degrees, Academic
Languages : en
Pages : 206

Book Description

Fraudulent Medical Degrees

Book Description

Prescription for Profit

Author: Paul Jesilow
Publisher: Univ of California Press
ISBN: 0520911830
Category : Medical
Languages : en
Pages : 366

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.