The role of the states in combating managed care fraud and abuse.
Professor Krause describes the weapons available to state regulators to address managed care fraud. Although many commentators have focused on recent federal anti-fraud efforts, Professor Krause argues that the states, through the use of a number of existing legal theories, have the most flexibility to combat fraudulent managed care practices. By using these targeted state-based efforts (in contrast to broader federal provisions), state regulators may be able to resolve problems more efficiently and with greater patient benefits.
Krause
J H
JH
Institute for Health Law, Loyola University of Chicago School of Law, USA.
D003254:Consumer Advocacy / Q000331:legislation & jurisprudence; D003363:Cost Control / Q000331:legislation & jurisprudence; D019461:Employee Retirement Income Security Act / Q000331:legislation & jurisprudence; D005161:Facility Regulation and Control / Q000331:legislation & jurisprudence; D005607:Fraud / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D007343:Insurance Carriers / Q000331:legislation & jurisprudence; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D013219:State Government; D014481:United States