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PRACTITIONER FRAUD AND ABUSE IN MEDICAL BENEFIT PROGRAMS: Government Regulation and Professional White‐Collar Crime
Author(s) -
PONTELL HENRY N.,
JESILOW PAUL D.,
GEIS GILBERT
Publication year - 1984
Publication title -
law and policy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.534
H-Index - 45
eISSN - 1467-9930
pISSN - 0265-8240
DOI - 10.1111/j.1467-9930.1984.tb00335.x
Subject(s) - white collar crime , government (linguistics) , state (computer science) , criminology , medicaid , socioeconomic status , enforcement , law enforcement , political science , business , medicine , psychology , law , environmental health , health care , linguistics , philosophy , population , algorithm , computer science
Physicians who defraud and abuse medical benefit programs provide a unique group of lawbreakers for scientific study. They could be considered to epitomize white collar criminals given their exceedingly high socioeconomic status and power as a professional group. Using official reports and documents, as well as interviews with enforcement and program personnel at both state and federal levels, this study examines the problem of physician fraud and abuse in Medicare and Medicaid. Major areas relevant to understanding this phenomenon and its control are presented and policy implications of present knowledge in the area are discussed.