Research Catalog

Title

License to steal : how fraud bleeds America's health care system / Malcolm K. Sparrow.

Author

Sparrow, Malcolm K.

Publication

Boulder, CO : Westview Press, 2000.

Items in the Library & Off-site

Details

Description

xx, 283 pages; 24 cm

Summary

• "Sparrow also examines the industry's response to the government's campaign against fraud and abuse. It appears that a significant segment of the industry regard fraud and abuse not as a problem, but as a lucrative enterprise worth defending."--BOOK JACKET.
• "Who steals our health care dollars? An extraordinary range of folk, from low-life hoods who sign on as Medicare or Medicaid providers, to drug trafficking organizations, crime syndicates, even major hospital chains. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well-orchestrated attacks.
• The highly automated claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention - and with the U.S. Treasury on the end of the electronic line.".

Subjects

• United States
• Medicaid
• Medicare
• Fraud
• Delivery of Health Care
• Medicaid fraud
• Medicare fraud
• Medical care > Corrupt practices > United States

Bibliography (note)

• Includes bibliographical references and index.

Contents

Pt. 1. The State of the Art. 1. Control Failures. 2. How Goes the War? -- Pt. 2. New Frontiers for Control. 3. False Claims. 4. Managed Care -- Pt. 3. The Nature of the Fraud-Control Challenge. 5. The Pathology of Fraud Control. 6. The Importance of Measurement. 7. Assessment of Existing Fraud-Control Systems. 8. The Antithesis of Modern Claims Processing -- Pt. 4. Prescription for Progress. 9. A Model Fraud-Control Strategy. 10. Detection Systems.

ISBN

0813368103 (alk. paper)

LCCN

00020812

Owning Institutions

Columbia University Libraries