Download or read book Prescription for Profit written by Paul Jesilow and published by Univ of California Press. This book was released on 2023-09-01 with total page 366 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Prescription for Fraud written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2001 with total page 68 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Phantom Billing Fake Prescriptions and the High Cost of Medicine written by Terry L. Leap and published by Cornell University Press. This book was released on 2011-04-15 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Health Care Fraud written by Williamd Edward Ackerman, III and published by Createspace Independent Publishing Platform. This book was released on 2017-09-24 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: The medical profession and health care in general has deteriorated over the past twenty years. It has become plagued with fraudulent behaviors. It is difficult for individuals to know if they are being scammed. Fraud unfortunately exists in all aspects of health care today. In 2011, $2.27 trillion was spent on health care and more than four billion health insurance claims were processed in the United States. It is an undisputed reality that some of these health insurance claims are fraudulent. No institution has undone more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that susceptible and sick Americans place in their healthcare. No doctor wants to be identified as being out of step with medical practice norms. Furthermore, most health care providers do not want a decrease in profit margins as well. This book is about the millions of Americans who have access to what some would call the best medical care in the world but are being swindled. Of course, there are millions of uninsured Americans whose access to care is heartlessly limited. The problems of fraudulent health care described in this book are less likely to transpire to the latter group, simply because they receive less medical care. This book is about the relentless expansion of medicine and our health providers increasing tendency to only make a diagnosis so that further treatments can be done to increase their revenues. Americans have been taught to be concerned about their health. We are all aware that types of hidden jeopardies prowl inside of us. The conventional wisdom is that it's always better to know about these dangers so that something can be done. That's why we are so enthusiastic about amazing medical technologies that can detect abnormalities even when we reason we are well. That's also why we welcome the identification of risk factors, disease awareness campaigns, cancer screening, genetic testing etc. Americans love a diagnosis so that they can receive attention and health care whether or not it helps them. But it's also true that we do receive too much of it in some circumstances. Some people are diagnosed and treated needlessly by swindlers who do unnecessary or dangerous treatments to increase their profit which is one reason why this book was written. Our legislators have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life. The majority of health care frauds are committed by a very small minority of dishonest health care providers. Unfortunately, the stock in trade of fraud-doers is to take advantage of the confidence that has been entrusted to them in order to commit ongoing fraud on a very broad scale. Another reason for this book is to inform individuals that rewards can be made by reporting health care fraud by becoming a whistle blower. Health care consumers need to identify these health care fraudsters and report them to ultimately attempt to salvage what remains of our health care structure. Fighting Medicare fraud is an important part of safeguarding our healthcare for future generations. Health deception costs Americans billions of dollars. We all must do our parts to reverse this trend. If you suspect that something has happened illegally with respect to medical care, then it is your duty to blow the whistle. Doing so makes you part of the solution. This book addresses the types of fraud which plague the healthcare industry and describes the most common fraudulent behavior throughout this industry and how to report fraud and possibly receive a reward. We must all do our part in trying to save our health care system!
Download or read book Prescription Fraud written by Julie Wartell and published by . This book was released on 2004 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Describes the problem of prescription fraud in the United States. Defines pharmaceutical diversion as the illegal acquisition of prescription drugs for person use or profit. Identifies a series of questions for analyzing a local situation, and reviews police responses and what is known about those responses from evaluative research and police practice.
Download or read book Bottle of Lies written by Katherine Eban and published by HarperCollins. This book was released on 2020-06-23 with total page 512 pages. Available in PDF, EPUB and Kindle. Book excerpt: A NEW YORK TIMES BESTSELLER New York Times 100 Notable Books of 2019 New York Public Library Best Books of 2019 Kirkus Reviews Best Health and Science Books of 2019 Science Friday Best Books of 2019 New postscript by the author From an award-winning journalist, an explosive narrative investigation of the generic drug boom that reveals fraud and life-threatening dangers on a global scale—The Jungle for pharmaceuticals Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, almost 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas. We have been reassured by our doctors, our pharmacists and our regulators that generic drugs are identical to their brand-name counterparts, just less expensive. But is this really true? Katherine Eban’s Bottle of Lies exposes the deceit behind generic-drug manufacturing—and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects. The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.
Download or read book Medicaid Drug Fraud written by United States. General Accounting Office and published by . This book was released on 1993 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid written by Gregory D. Kutz and published by DIANE Publishing. This book was released on 2010-06 with total page 41 pages. Available in PDF, EPUB and Kindle. Book excerpt: One significant cost to Medicaid is prescription drugs, which accounted for over $23 billion in FY 2008, or about 7% of total Medicaid outlays. Many of these drugs are susceptible to abuse and include pain relievers and stimulants that are on the Drug Enforcement Administration's Schedule of Controlled Substances. This report determined: (1) whether there are indications of fraud and abuse related to controlled substances paid for by Medicaid; (2) if so, examples of fraudulent, improper, and abusive activity; and (3) the effectiveness of internal controls that the fed. gov¿t. and selected states have in place to prevent fraud and abuse related to controlled substances. Includes recommendations. Charts and tables.
Download or read book Prescription Fraud and Abuse 2nd Ed written by Julie Wartell and published by . This book was released on 2013-04-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicaid Prescription Drug Diversion written by Janet Shikles and published by . This book was released on 1992 with total page 20 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Pharmacy Practice and Tort Law written by Fred Weissman and published by McGraw Hill Professional. This book was released on 2016-06-22 with total page 224 pages. Available in PDF, EPUB and Kindle. Book excerpt: The only comprehensive tort law book featuring real-life federal cases for the practicing pharmacist As tort law and tort liability cases, both civil and administrative, continue to increase in the pharmacy practice, now more than ever, it is imperative for students and practitioners to understand the civil liability a pharmacist may face. Between intentional torts, negligence, vicarious liability, defamation, invasion of privacy, and more, practitioners and practitioners-to-be need to grasp the intricacies of the law in this landscape of increased litigation. Pharmacy Practice and Tort Law introduces students not only to the civil action cases related to pharmacy practice, but also provides explanation on how tort rules apply to the facts of a given case. Each type of civil action is described in detail, outlining the elements that must be proven for successful litigation, followed by detailed explanation of actual federal cases and their outcomes, illustrating how a case can be successful or unsuccessful.
Download or read book Medicaid Fraud prescription Drug Diversion written by United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee and published by . This book was released on 1995 with total page 110 pages. Available in PDF, EPUB and Kindle. Book excerpt: Distributed to some depository libraries in microfiche.
Download or read book The Physician and Pharmacist written by and published by . This book was released on 1868 with total page 314 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book How to Spot Health Fraud written by and published by DIANE Publishing. This book was released on with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt: The U.S. Food and Drug Administration (FDA) features the full text of an article entitled "How To Spot Health Fraud," written by Paula Kurtzweil. The article appeared in the November-December 1999 issue of the FDA's "Consumer Magazine." The author highlights tips for recognizing health fraud.
Download or read book Medicare Program Integrity written by Kathleen M. King and published by . This book was released on 2015-01-01 with total page 39 pages. Available in PDF, EPUB and Kindle. Book excerpt: Recent media reports and law enforcement actions have highlighted the problem of prescription drug fraud, waste, and abuse in the U.S. Medicare, and the Part D prescription drug benefit, are susceptible to such fraud -- a risk made greater by Medicare's size, scope, and complexity. Questions have been raised about the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services' (CMS's) oversight of its activities to address fraud, waste, and abuse in Part D, as well as oversight of the contractors tasked with this work. This report examined: (1) practices for promoting prescription drug program integrity; and (2) the extent that CMS's oversight of Medicare Part D program integrity, including the program integrity contractors, reflects these practices. Tables and figures. This is a print on demand report.
Download or read book Computer Fraud Casebook written by Joseph T. Wells and published by John Wiley & Sons. This book was released on 2009-01-23 with total page 531 pages. Available in PDF, EPUB and Kindle. Book excerpt: This one-of-a-kind collection consists of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of computer fraud how they are investigated, across industries and throughout the world. Topics included are email fraud, on-line auction fraud, security breaches, counterfeiting, and others.
Download or read book Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence written by World Health Organization. Department of Mental Health and Substance Abuse and published by World Health Organization. This book was released on 2009 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: "These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv
