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Fraud and Abuse

  • Health Care Fraud

    Adequate safeguards against health care fraud are essential to the proper functioning of any health care system. This analysis examines health care fraud in the U.S., and its findings underscore the importance to national health reform of comprehensive anti-fraud protections covering both public and private health insurance industry.
    Sara Rosenbaum
    Nancy Lopez
    Scott Stifler
    October 2009
  • Health Insurance Fraud: An Overview

    Fraud is an unfortunate but real part of the health care landscape. As health reform legislation takes shape anti-fraud provisions will be critical. This means considering steps to strengthen the reach and scope of the HIPAA insurance fraud provisions of 1996, requiring anti-fraud compliance procedures for all insurers participating in a reformed health care system, and sufficiently funding federal and state agencies to ensure that cases of fraud are quickly detected and addressed.
    Sara Rosenbaum
    Nancy Lopez
    Scott Stifler
    June 2009