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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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(p.177) Conclusion
Phantom Billing, Fake Prescriptions, and the High Cost of Medicine

Terry L. Leap

Cornell University Press

This book concludes by revisiting several broad questions that are integral to health care fraud and abuse: whether the current definitions of “fraud” and “abuse” are too broad; whether certain institutional arrangements such as fee-for-service systems or capitation plans are more (or less) conducive to fraud and abuse; and how effective the current laws and regulations for fighting health care fraud are. It also considers the role of for-profit health care in reducing fraud, along with health care arrangements, financial incentives, and technologies that can be used to curb fraud and abuse. Finally, it proposes a two-pronged approach to reducing health care fraud and abuse: first, recognizing that fraud and abuse start with health care providers and second, educating health care consumers about the impact of fraud and abuse on their lives and how they can take an active role in reporting and stopping it.

Keywords:   health care fraud, fee-for-service systems, capitation plans, laws, regulations, for-profit health care, financial incentives, health care providers, health care consumers

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