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Health Care Fraud and Abuse: A Tale of Behavior Induced by Payment Structure

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  • Rai, Arti K

Abstract

The campaign to curtail "fraud and abuse" in the Medicare and Medicaid programs represents an attempt by regulators to evade more fundamental and difficult questions regarding cost and quality control. In the Medicare arena, tackling these larger questions will require dismantling the program's fee-for-service structure and imposing on providers financial incentives to evaluate carefully health care costs and benefits. Copyright 2001 by the University of Chicago.

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  • Rai, Arti K, 2001. "Health Care Fraud and Abuse: A Tale of Behavior Induced by Payment Structure," The Journal of Legal Studies, University of Chicago Press, vol. 30(2), pages 579-587, June.
    • Handle: RePEc:ucp:jlstud:v:30:y:2001:i:2:p:579-87
    DOI: 10.1086/339292
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    Cited by:

    1. Rajeev K. Goel, 2020. "Medical professionals and health care fraud: Do they aid or check abuse?," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 41(4), pages 520-528, June.
    2. Rajeev K. Goel, 2021. "Are health care scams infectious? Empirical evidence on contagion in health care fraud," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(1), pages 198-208, January.
    3. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March.
    4. Thuy Nguyen & Victoria Perez, 2020. "Privatizing Plaintiffs: How Medicaid, the False Claims Act, and Decentralized Fraud Detection Affect Public Fraud Enforcement Efforts," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 87(4), pages 1063-1091, December.
    5. Pulina, Manuela & Paba, Antonello, 2010. "A discrete choice approach to model credit card fraud," MPRA Paper 20019, University Library of Munich, Germany.

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