Penalties for health care fraud and abuse: January 2007-March 2008.
This commentary details the providers, penalties, and affected regions resulting from US health care fraud and abuse prosecutions from January 2007 to March 2008. Database review found that over $3 billion in fines as well as incarceration in some cases were ordered for 21 convicted providers, 68 percent of whom were physicians, and to 41 nonproviders, most of whom were vendors of durable medical goods (36%), individual citizens (18%) and health care corporations (17%). Fewer claims were found against pharmaceutical firms (7%) and medical equipment manufacturers (4%). Most verdicts were in the state of Florida. False claims accounted for most of the violations for both providers and nonproviders. These severe repercussions of malfeasance should promote careful consideration and construction of the terms of engagement between health care providers, corporations, and payers.
Shah
Udayan K
UK
Division of Otolaryngology, Department of Surgery, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA. ushah@nemours.org
Johnston
Douglas R
DR
Smith
Gina Maisto
GM
Ziv
Barbara E
BE
Reilly
James S
JS
D005607:Fraud / Q000191:economics* / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D006801:Humans; D035846:Law Enforcement; D014481:United States