LEADER 04112oam 22006494a 450 001 9910456563203321 005 20210915034836.0 010 $a0-8014-6080-8 024 7 $a10.7591/9780801460807 035 $a(CKB)2550000000036228 035 $a(OCoLC)731128347 035 $a(CaPaEBR)ebrary10468006 035 $a(SSID)ssj0000529836 035 $a(PQKBManifestationID)11347686 035 $a(PQKBTitleCode)TC0000529836 035 $a(PQKBWorkID)10557396 035 $a(PQKB)11391539 035 $a(StDuBDS)EDZ0001496087 035 $a(MiAaPQ)EBC3138127 035 $a(MdBmJHUP)muse28843 035 $a(DE-B1597)478351 035 $a(OCoLC)979575382 035 $a(DE-B1597)9780801460807 035 $a(Au-PeEL)EBL3138127 035 $a(CaPaEBR)ebr10468006 035 $a(CaONFJC)MIL839063 035 $a(EXLCZ)992550000000036228 100 $a20100927d2011 uy 0 101 0 $aeng 135 $aur||||||||||| 181 $ctxt 182 $cc 183 $acr 200 10$aPhantom Billing, Fake Prescriptions, and the High Cost of Medicine$eHealth Care Fraud and What to Do about It /$fTerry L. Leap 210 1$aIthaca :$cILR Press,$d2011. 210 4$dİ2011. 215 $a1 online resource (251 p.) 225 0 $aThe culture and politics of health care work 300 $aBibliographic Level Mode of Issuance: Monograph 311 $a0-8014-4979-0 320 $aIncludes bibliographical references and index. 327 $aHealth care fraud and its facilitating crimes -- The major health care fraud laws -- Fraud in fee-for-service and managed care : different sides of the same coin -- Fraud at major hospitals : profits at any cost, part 1 -- Fraud in the pharmaceutical, medical equipment, and supply industries : profits at any cost, part 2 -- Fighting health care fraud and abuse. 330 $aU.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 $251 million through false claims for services that were medically unnecessary or never provided. These cases only hint at the scope of the problem.In Phantom Billing, Fake Prescriptions, and the High Cost of Medicine, Terry L. Leap takes on medical fraud and its economic, psychological, and social costs. Illustrated throughout with dozens of specific and often fascinating cases, this book covers a wide variety of crimes: kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud, as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering).After assessing the effectiveness of the federal laws designed to fight health care fraud and abuse-the antikickback statute, the Stark Law, the False Claims Act, HIPAA, and the food and drug laws-Leap suggests a number of ways that health care providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control, thereby reducing the overall cost of medical care in America. 410 0$aCulture and politics of health care work. 606 $aFraud$zUnited States 606 $aMedical care$xCorrupt practices$zUnited States 608 $aElectronic books. 615 0$aFraud 615 0$aMedical care$xCorrupt practices 676 $a364.16/3 700 $aLeap$b Terry L.$f1948-$01025590 801 0$bMdBmJHUP 801 1$bMdBmJHUP 906 $aBOOK 912 $a9910456563203321 996 $aPhantom Billing, Fake Prescriptions, and the High Cost of Medicine$92438912 997 $aUNINA