Healthcare fraud and quality of care: a patient-centered approach.
This Article explores the intersection between quality of care and healthcare fraud by examining the extent to which quality-related fraud settlements benefit patients. The author argues that, although the protection of beneficiary health and welfare often is invoked by the federal government as one of the reasons for undertaking anti-fraud efforts, such considerations do not appear to play a large role in many of the settlements that are negotiated. While returning funds to the federal Treasury helps to ensure that the federal healthcare programs remain solvent and continue to serve beneficiaries in the aggregate, it may not adequately address harm to individual patients. Thus, the author concludes it may be time to explore new models of fraud settlements that can provide adequate compensation to the patients who may have suffered harm.
Krause
Joan H
JH
Health Law & Policy Institute, University of Houston Law Center, USA.
D035881:Compensation and Redress / Q000331:legislation & jurisprudence*; D005607:Fraud / Q000331:legislation & jurisprudence*; D006801:Humans; D016365:Liability, Legal / Q000191:economics*; D019300:Medical Errors / Q000191:economics; D017008:Negotiating; D010344:Patient Advocacy; D011785:Quality Assurance, Health Care; D014481:United States