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Detecting Medicare abuse

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  • Becker, David
  • Kessler, Daniel
  • McClellan, Mark

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  • Becker, David & Kessler, Daniel & McClellan, Mark, 2005. "Detecting Medicare abuse," Journal of Health Economics, Elsevier, vol. 24(1), pages 189-210, January.
    • Handle: RePEc:eee:jhecon:v:24:y:2005:i:1:p:189-210
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    1. Dwayne Banks & Elliott Parker & Jeanne Wendel, 2001. "Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 119-134, March.
    2. Henry Hansmann & Daniel Kessler & Mark B. McClellan, 2003. "Ownership Form and Trapped Capital in the Hospital Industry," NBER Chapters, in: The Governance of Not-for-Profit Organizations, pages 45-70, National Bureau of Economic Research, Inc.
    3. Robinson, James C, 1996. "Administered Pricing and Vertical Integration in the Hospital Industry," Journal of Law and Economics, University of Chicago Press, vol. 39(1), pages 357-378, April.
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    5. Daniel P. Kessler & Mark B. McClellan, 2002. "The Effects of Hospital Ownership on Medical Productivity," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 488-506, Autumn.
    6. Porter, Robert H & Zona, J Douglas, 1993. "Detection of Bid Rigging in Procurement Auctions," Journal of Political Economy, University of Chicago Press, vol. 101(3), pages 518-538, June.
    7. James Andreoni & Brian Erard & Jonathan Feinstein, 1998. "Tax Compliance," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 818-860, June.
    8. Rose-Ackerman, Susan, 1975. "The economics of corruption," Journal of Public Economics, Elsevier, vol. 4(2), pages 187-203, February.
    9. Dubin, Jeffrey A. & Graetz, Michael J. & Wilde, Louis L., 1990. "The Effect of Audit Rates on the Federal Individual Income Tax, 1977-1986," National Tax Journal, National Tax Association;National Tax Journal, vol. 43(4), pages 395-409, December.
    10. Elaine Silverman & Jonathan Skinner, 2001. "Are For-Profit Hospitals Really Different? Medicare Upcoding and Market Structure," NBER Working Papers 8133, National Bureau of Economic Research, Inc.
    11. Paolo Mauro, 1995. "Corruption and Growth," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(3), pages 681-712.
    12. Raymond Fisman, 2001. "Estimating the Value of Political Connections," American Economic Review, American Economic Association, vol. 91(4), pages 1095-1102, September.
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    Cited by:

    1. Jonas Heese, 2017. "The Role of Overbilling in Hospitals’ Earnings Management Decisions," Harvard Business School Working Papers 18-026, Harvard Business School.
    2. Howard, David H. & McCarthy, Ian, 2021. "Deterrence effects of antifraud and abuse enforcement in health care," Journal of Health Economics, Elsevier, vol. 75(C).
    3. Renee Flasher & Melvin A. Lamboy-Ruiz, 2019. "Impact of Enforcement on Healthcare Billing Fraud: Evidence from the USA," Journal of Business Ethics, Springer, vol. 157(1), pages 217-229, June.
    4. Barro, Jason R. & Huckman, Robert S. & Kessler, Daniel P., 2006. "The effects of cardiac specialty hospitals on the cost and quality of medical care," Journal of Health Economics, Elsevier, vol. 25(4), pages 702-721, July.
    5. Zantomio, Francesca, 2013. "Older people's participation in extra-cost disability benefits," Journal of Health Economics, Elsevier, vol. 32(1), pages 320-330.
    6. Farbmacher, Helmut & Löw, Leander & Spindler, Martin, 2022. "An explainable attention network for fraud detection in claims management," Journal of Econometrics, Elsevier, vol. 228(2), pages 244-258.
    7. Kang, HeeChung & Hong, JaeSeok & Lee, KwangSoo & Kim, Sera, 2010. "The effects of the fraud and abuse enforcement program under the National Health Insurance program in Korea," Health Policy, Elsevier, vol. 95(1), pages 41-49, April.
    8. Shubhranshu Shekhar & Jetson Leder-Luis & Leman Akoglu, 2023. "Unsupervised Machine Learning for Explainable Health Care Fraud Detection," NBER Working Papers 30946, National Bureau of Economic Research, Inc.
    9. Heike Hennig‐Schmidt & Hendrik Jürges & Daniel Wiesen, 2019. "Dishonesty in health care practice: A behavioral experiment on upcoding in neonatology," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 319-338, March.
    10. Kuhn, Michael & Siciliani, Luigi, 2013. "Manipulation and auditing of public sector contracts," European Journal of Political Economy, Elsevier, vol. 32(C), pages 251-267.
    11. Jason Sutherland & Jeremy Hamm & Jeff Hatcher, 2010. "Adjusting case mix payment amounts for inaccurately reported comorbidity data," Health Care Management Science, Springer, vol. 13(1), pages 65-73, March.
    12. Sutherland, Jason M. & Steinum, Olafr, 2009. "Hospital factors associated with clinical data quality," Health Policy, Elsevier, vol. 91(3), pages 321-326, August.
    13. Arash Rashidian & Hossein Joudaki & Taryn Vian, 2012. "No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse: A Systematic Review of Literature," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-8, August.
    14. Steinbusch, Paul J.M. & Oostenbrink, Jan B. & Zuurbier, Joost J. & Schaepkens, Frans J.M., 2007. "The risk of upcoding in casemix systems: A comparative study," Health Policy, Elsevier, vol. 81(2-3), pages 289-299, May.

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