IDEAS home Printed from https://ideas.repec.org/p/jmp/jm2019/ple1069.html
   My bibliography  Save this paper

Whistleblowers, The False Claims Act, and the Behavior of Healthcare Providers

Author

Listed:
  • Jetson Leder-Luis

Abstract

This paper studies the effects of litigation by whistleblowers against healthcare providers for misreporting claims for payment to the Medicare program. Under the U.S. False Claims Act, whistleblowers bring lawsuits on behalf of the government in exchange for a share of recovered payments. I combine a new dataset on whistleblower cases from the Department of Justice with the universe of Medicare Fee- for-Service claims from 1999-2016. First, I measure the deterrence effects of successful whistleblowing lawsuits using a synthetic control design. I find that whistleblower settlements totaling to $1.9 billion in recovery generated future cost savings of more than $18 billion over 5 years. Next, I examine how whistleblowing impacts care decisions by providers. Using a case study of spine procedures for osteoporotic patients, I find that after a whistleblower settlement, care shifted from inpatient to less-expensive outpatient treatment and towards patients with the greatest expected benefit.

Suggested Citation

  • Jetson Leder-Luis, 2019. "Whistleblowers, The False Claims Act, and the Behavior of Healthcare Providers," 2019 Papers ple1069, Job Market Papers.
  • Handle: RePEc:jmp:jm2019:ple1069
    as

    Download full text from publisher

    File URL: https://ideas.repec.org/jmp/2019/ple1069.pdf
    Download Restriction: no
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Howard, David H. & McCarthy, Ian, 2021. "Deterrence effects of antifraud and abuse enforcement in health care," Journal of Health Economics, Elsevier, vol. 75(C).

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption
    • K15 - Law and Economics - - Basic Areas of Law - - - Civil Law; Common Law
    • M48 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Accounting - - - Government Policy and Regulation

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:jmp:jm2019:ple1069. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://ideas.repec.org/jmp.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Christian Zimmermann (email available below). General contact details of provider: https://ideas.repec.org/jmp.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.