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Reducing Waste through Anti-Fraud Enforcement: Evidence from Hospital Admission Cases

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  • David H. Howard
  • Jetson Leder-Luis

Abstract

The use of federal anti-fraud laws to address unnecessary medical care is controversial. Targeted providers frequently argue that, in their judgment, the treatment in question was appropriate. We examine the effects of anti-fraud litigation against hospitals for over-admitting patients from the emergency department, using 100% Medicare claims for 2005-2019 and a design based on the staggered rollout of these lawsuits. We find that anti-fraud lawsuits reduced admission rates by 3.6 percentage points without increasing mortality rates. We estimate five-year savings to Medicare of $1.3 billion. Our results suggest that anti-fraud enforcement can be successful in reducing costly, unnecessary care.

Suggested Citation

  • David H. Howard & Jetson Leder-Luis, 2026. "Reducing Waste through Anti-Fraud Enforcement: Evidence from Hospital Admission Cases," NBER Working Papers 34938, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:34938
    Note: AG EH LE
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    References listed on IDEAS

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    1. Jetson Leder-Luis, 2025. "Can Whistleblowers Root Out Public Expenditure Fraud? Evidence from Medicare," The Review of Economics and Statistics, MIT Press, vol. 107(5), pages 1169-1186, September.
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    More about this item

    JEL classification:

    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption
    • 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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