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Ambulance Taxis: The Impact of Regulation and Litigation on Health-Care Fraud

Author

Listed:
  • Paul Eliason
  • Riley League
  • Jetson Leder-Luis
  • Ryan C. McDevitt
  • James W. Roberts

Abstract

We study the effectiveness of pay-and-chase lawsuits and up-front regulations for combating health-care fraud. Between 2003 and 2017, Medicare spent $7.7 billion on 37.5 million regularly scheduled ambulance rides for patients traveling to and from dialysis facilities even though many did not satisfy Medicare’s criteria for receiving reimbursements. Using an identification strategy based on the staggered timing of regulations and lawsuits across the United States, we find that adding a prior authorization requirement for ambulance reimbursements reduced spending much more than pursuing criminal and civil litigation did on their own. We find no evidence that prior authorization affected patients’ health.

Suggested Citation

  • Paul Eliason & Riley League & Jetson Leder-Luis & Ryan C. McDevitt & James W. Roberts, 2025. "Ambulance Taxis: The Impact of Regulation and Litigation on Health-Care Fraud," Journal of Political Economy, University of Chicago Press, vol. 133(5), pages 1661-1702.
    • Handle: RePEc:ucp:jpolec:doi:10.1086/734134
    DOI: 10.1086/734134
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    Cited by:

    1. 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.
    2. O'Malley, A. James & Bubolz, Thomas A. & Skinner, Jonathan S., 2023. "The diffusion of health care fraud: A bipartite network analysis," Social Science & Medicine, Elsevier, vol. 327(C).

    More about this item

    JEL classification:

    • D22 - Microeconomics - - Production and Organizations - - - Firm Behavior: Empirical Analysis
    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption
    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law

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