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Workers' compensation fraud and the physician.

Elizabeth Genovese1

  • 1University of Pennsylvania Medical Center, Philadelphia, USA. elizbethgenovese@msn.com

Clinics in Occupational and Environmental Medicine
|June 9, 2004
PubMed
Summary

Healthcare fraud, driven by economic incentives, impacts workers' compensation costs. Providers can mitigate fraud by maintaining ethical practices and objective patient evaluations.

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Area of Science:

  • Healthcare Economics
  • Medical Ethics
  • Public Health Policy

Background:

  • Healthcare professionals may prioritize economic gain over ethical standards, leading to fraudulent activities.
  • Fraudulent actions within the healthcare system can significantly inflate workers' compensation costs.
  • Providers managing workers' compensation cases have limited influence over employer or insurer fraud.

Purpose of the Study:

  • To explore the impact of economic incentives on healthcare provider behavior.
  • To identify strategies for healthcare providers to combat patient and provider fraud.
  • To understand how ethical practices can mitigate fraud in the workers' compensation system.

Main Methods:

  • Analysis of factors contributing to fraudulent behavior in healthcare.
  • Review of ethical and practice management strategies.
  • Examination of the role of objectivity in patient evaluations.

Main Results:

  • Individual economic incentives can override ethical and societal standards in healthcare.
  • Provider and patient fraud can be minimized through ethical practice and objective assessments.
  • Understanding and managing fraudulent behavior is crucial for healthcare providers.

Conclusions:

  • Ethical practice and objective evaluations are key to reducing healthcare fraud.
  • Healthcare providers play a vital role in preventing fraud within the workers' compensation system.
  • Addressing the root causes of fraud is essential for the integrity of the workers' compensation system.
Keywords:
Health Care and Public Health

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