1st Edition

License To Steal How Fraud Bleeds America's Health Care System, Updated Edition

By Malcolm K. Sparrow Copyright 1996
    256 Pages
    by Routledge

    256 Pages
    by Routledge

    This book brings an unusual opportunity to explore the peculiarities of America's health care industry's approach to fraud control, when compared with the financial services sector, credit card companies, or the Internal Revenue Service—all of which have to defend themselves against fraud.

    Foreword -- Preface -- Introduction -- Understanding the Fraud-Control Challenge -- The Pathology of Fraud Control -- Particular Challenges in the Health Care Field -- The Importance of Measurement -- Assessment of Fraud-Control Systems -- The Antithesis of Modern Claims Processing -- Current Developments -- Electronic Claims Processing -- Managed Care -- Prescription for Progress -- A Model Fraud-Control Strategy -- Detection Systems -- Conclusion -- Appendix: Site Selection and Interview Subjects