NCJ Number
144754
Date Published
1993
Length
258 pages
Annotation
This book documents the types of fraud some doctors in the U.S. perpetuate against the Medicaid system. The authors attempt to catalogue the offenses and to profile the offenders.
Abstract
The first two chapters prepare the context for the remainder of the book by discussing various earlier forms of crime by medical doctors, the tension between the practice of medicine as a profession and as a business, and the changes wrought in both of those aspects of medicine by the Medicare and Medicaid systems. The authors highlight the conflict between the ideals envisioned for Medicaid and the later consequences of rapidly escalating costs. Subsequent chapters are based on interviews with Federal, State, and private officials, and on case file information, dealing with enforcement problems related to medical fraud and to the kinds of offenses that lead to formal investigation and criminal charges. Data gathered from interviews with apprehended violators are used to analyze the perceptions doctors have of what happened to them and how they view the Medicaid program. The final chapter compares Medicare and Medicaid to the national health services of Canada, Britain, and Australia, in an attempt to clarify some factors related to physician fraud. Chapter references