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Book
Prescription for Profit : How Doctors Defraud Medicaid
Authors: --- ---
ISBN: 0520911830 0585299528 9780520911833 9780585299525 Year: 1993 Publisher: Berkeley, California : University of California Press,

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Abstract

In this explosive exposé of our health care system, Paul Jesilow, Henry N. Pontell, and Gilbert Geis uncover the dark side of physician practice. Using interviews with doctors and federal, state, and private officials and extensive investigation of case files, they tell the stories of doctors who profit from abortions on women who aren't pregnant, of needless surgery, overcharging for services, and excessive testing.How can doctors, recipients of a sacred trust and sworn to the Hippocratic Oath, violate Medicaid so egregiously? The authors trace patterns of abuse to the program's inauguration in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgment.The medical profession has not accepted the gravity or extent of some members' illegal behavior, and individual doctors continue to blame violations on subordinates and patients. In the meantime, program guidelines have grown more confusing, hamstringing efforts to detect, apprehend, and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit program has allowed self-serving and greedy practitioners to violate the law with impunity.Prescription for Profit is a shocking revelation of abuse within a once-hallowed profession. It is a book that every doctor, and every patient, needs to read this year.

Keywords

Medicaid fraud --- Physicians --- Fraud. --- Medicaid. --- Physicians. --- Insurance Claim Reporting. --- Fraud --- Swindlers and swindling --- Physician --- Claim Reporting, Insurance --- Reporting, Insurance Claim --- Dental Medicaid Programs --- Medicaid Program, Dental --- Medicaid Programs, Dental --- Dental Medicaid Program --- Medical Assistance, Title 19 --- Program, Dental Medicaid --- Programs, Dental Medicaid --- Drug Counterfeiting --- Healthcare Fraud --- Fraud, Health Care --- Health Care Fraud --- Kickbacks --- Counterfeiting, Drug --- Fraud, Healthcare --- Health Care Frauds --- Kickback --- Deception --- Professional Misconduct --- Malpractice --- United States. --- Allopathic doctors --- Doctors --- Doctors of medicine --- MDs (Physicians) --- Medical doctors --- Medical profession --- Medical personnel --- Medicine --- abortions. --- american government. --- american healthcare system. --- american politics. --- case files. --- doctors. --- excessive testing. --- federal government. --- fee for service policy. --- fraud control. --- fraud. --- guilty doctors. --- health care. --- health. --- illegal behavior. --- medicaid. --- medical benefit programs. --- medical business. --- medical care. --- medical insurance. --- medical profession. --- medicare. --- medicine. --- national health service. --- needless surgery. --- overcharging. --- patients. --- patterns of abuse. --- physician practices. --- program guidelines. --- self serving. --- subordinates. --- violations. --- Medicaid fraud.

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