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NCJ Number: 42151 Add to Shopping cart Find in a Library
Title: PROGRESS IN THE WAR ON MEDICAID FRAUD
Journal: SOCIAL AND REHABILITATION RECORD  Volume:1  Issue:2  Dated:(MAY 1977)  Pages:24-27
Corporate Author: US Dept of Health, Education, and Welfare
Social & Rehabilitation Service
United States of America
Editor(s): M JUDGE
Date Published: 1977
Page Count: 4
Sponsoring Agency: US Dept of Health, Education, and Welfare
Washington, DC 20024
Format: Article
Language: English
Country: United States of America
Annotation: THERE HAS BEEN SIGNIFICANT PROGRESS IN CURBING THE EXTENT OF MEDICAID ABUSE, BUT NOT AS MUCH AS SOME WOULD LIKE.
Abstract: COMPUTERIZATION OF THE MEDICAID SYSTEM IN SEVERAL STATES HAS BEEN A BIG HELP. THE SYSTEM CAN BE PROGRAMMED TO IDENTIFY PHYSICIANS WHO PERFORM AN ABOVE AVERAGE NUMBER OF SURGICAL PROCEDURES OR CLINICAL LABORATORY TESTS. IT CAN ALSO DETECT DUPLICATE BILLING FOR THE SAME SERVICE BY COMPARING THE TYPES OF SERVICES, DATE THEY WERE RENDERED, AND THE COST ON THE INVOICES. THE SYSTEM CAN ALSO DETECT PING-PONGING, A PRACTICE WHERE A PATIENT IS REFERRED BACK AND FORTH FROM ONE MEDICAL PRACTITIONER TO ANOTHER. ANOTHER FACTOR THAT HAS HELPED CONSIDERABLY HAS BEEN THE STRICTER ATTITUDE OF PROSECUTORS IN CRACKING DOWN ON SUSPECTED ABUSE....BDS
Index Term(s): Crime costs; Crime prevention measures; Embezzlement; Fraud; Medical and dental services; Medical costs; White collar crime
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http://www.ncjrs.gov/App/publications/abstract.aspx?ID=42151

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