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1.
J Health Polit Policy Law ; 25(2): 283-308, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10946381

ABSTRACT

The Department of Justice (DOJ) reports that after violent crime, health care fraud is the department's top priority. The number of health care fraud investigations pending at the DOJ increased from 270 cases in 1992 to more than 4,000 in 1997. The DOJ's primary weapon in prosecuting health care fraud is the federal False Claims Act (FCA) of 1863 (31 U.S.C. secs. 3729-3733). Almost unique among federal antifraud provisions, the FCA may also be used by "private prosecutors" to file lawsuits on behalf of the federal government charging organizations with submitting false claims to the government. The FCA rewards such whistle-blowers with a share of any resulting recoveries as a bounty and protects them from discharge for filing false claims lawsuits against their employers. It also requires defendants to pay the costs and attorneys fees of successful claimants. Although the private "bounty hunter" features of the FCA data back to the Civil War, these so-called qui tam claims were nearly dormant until 1986, when Congress amended the FCA to revive their use. Following the 1986 amendments, and paralleling the rapid increase in federal reimbursements for health care costs, private qui tam claims have far expanded beyond their traditional purview of defense contracts into the field of health care. By 1997, health care providers were the targets of 54 percent of the 530 private qui tam lawsuits field that year.


Subject(s)
Fraud/legislation & jurisprudence , Guideline Adherence/legislation & jurisprudence , Health Care Sector/legislation & jurisprudence , Insurance, Health, Reimbursement/legislation & jurisprudence , Liability, Legal/economics , Truth Disclosure , Fraud/statistics & numerical data , Fraud/trends , Government Agencies , Humans , Motivation , United States , United States Dept. of Health and Human Services
2.
J Health Adm Educ ; 16(4): 403-24, 1998.
Article in English | MEDLINE | ID: mdl-10350871

ABSTRACT

The Socratic Method has long been recognized by the legal profession as an effective tool for promoting critical thinking and analysis in the law. This article describes ways the technique can be used in health administration education to help future administrators develop the "ethical rudder" they will need for effective leadership. An illustrative dialogue is provided.


Subject(s)
Ethics, Institutional , Hospital Administration/education , Models, Educational , Teaching/methods , Faculty , Health Services Administration , Judgment , Leadership , Managed Care Programs , Negotiating , Patient-Centered Care , Students , Systems Analysis , United States
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