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Phantom Billing, Fake Prescriptions, and the High Cost of MedicineHealth Care Fraud and What to Do about It$
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Terry L. Leap

Print publication date: 2011

Print ISBN-13: 9780801449796

Published to Cornell Scholarship Online: August 2016

DOI: 10.7591/cornell/9780801449796.001.0001

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Fraud at Major Hospitals

Fraud at Major Hospitals

Profits at Any Cost, Part One

(p.97) 4 Fraud at Major Hospitals
Phantom Billing, Fake Prescriptions, and the High Cost of Medicine

Terry L. Leap

Cornell University Press

This chapter examines frauds instigated by major hospitals. A company's fixation on financial performance, especially bottom-line profits and stock market prices, may lead to overcharges, false billings, upcoding, and kickbacks as well as accounting and financial fraud. Accounting fraud occurs when accounting documents and journal entries are manipulated to hide the embezzlement or the misappropriation of funds. Accounting fraud also forms the foundation for financial fraud. This chapter considers three cases of health care fraud and abuse involving Tenet Healthcare Corporation, the Hospital Corporation of America, and HealthSouth. It also discusses anti-trust violations that drive up costs and reduce the quality of health care, with particular attention to frauds committed by both large and small health care institutions. The chapter concludes with an analysis of organized crime's involvement in health care fraud.

Keywords:   hospitals, profits, accounting fraud, financial fraud, health care fraud, Tenet Healthcare Corporation, Hospital Corporation of America, HealthSouth, anti-trust violations, organized crime

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