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基因检测中的欺诈:欺骗系统

Rachel Notestine1, Claire N Singletary2, Meagan Choates3

  • 1University of Texas MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, Houston, TX.

Genetics in medicine : official journal of the American College of Medical Genetics
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概括

医疗欺诈是基因测试中的一个日益严重的问题. 这项研究分析了42起案件,揭示了常见的欺诈计划及其后果,强调需要对遗传测试索赔进行专家监督.

关键词:
欺诈 欺诈 欺诈 欺诈 欺诈基因检测是一种基因检测.医疗保健的质量 医疗保健的质量保险索赔审查对保险索赔进行审查.回的回扣,就是回扣.访问 访问 访问 访问评估和评价以及评估和评价.

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科学领域:

  • 医学经济学 医学经济学
  • 法医科学 法医科学 法医科学
  • 遗传学 是一个遗传学.

背景情况:

  • 医疗欺诈构成了美国医疗保健支出的很大一部分,影响了纳税人,患者和整个系统.
  • 不断扩大的基因测试行业为欺诈活动提供了越来越多的机会.
  • 尽管受到联邦政府的关注,但对基因检测欺诈的研究仍然有限.

研究的目的:

  • 调查和识别在基因测试部门中普遍存在的医疗欺诈主题和特征.
  • 分析用于基因测试欺诈的方法和随后的后果.
  • 为医疗保健提供者和利益相关者提供有关识别和预防基因测试欺诈的信息.

主要方法:

  • 一个回顾性审查42例门诊基因检测欺诈案件.
  • 数据来源于联邦网站,新闻文章和法律数据库.
  • 诱导传统内容分析,以识别欺诈活动中的主题.

主要成果:

  • 确定了欺诈性主题:欺诈性索赔,回扣,缺乏患者联系,不当的计费/文件,以及隐策略.
  • 对犯罪者的后果包括罚款,监禁,商业限制和财产没收.
  • 在欺诈案件中经常观察到医学上不合适的测试.

结论:

  • 医学上不合适的测试的普遍性强调了遗传学专家在订购和审查遗传测试索赔方面的关键作用.
  • 了解基因检测欺诈模式有助于提供者进行检测和报告.
  • 分析有助于提高对遗传检测行业最佳资源配置的认识.