举报人可以根除公共开支欺诈吗? 来自医疗保险的证据
1Boston University Questrom School of Business and NBER.
概括
"虚假索赔法"的私人执法可以阻止医疗保健提供者对政府的欺诈行为. 举报人和解节省了近190亿美元的医疗保险费用,证明了成本有效的欺诈减少.
科学领域:
- 卫生经济学 卫生经济学
- 公共政策 公共政策
- 法律和经济学 法律和经济学
背景情况:
- "虚假索赔法"鼓励举报人报告医疗保健欺诈行为.
- 医疗保健提供者对医疗保险的欺诈行为对政府支出造成了重大财政负担.
研究的目的:
- 根据"虚假索赔法"分析私人反欺诈执法的有效性和成本效益.
- 量化举报人和解对医疗保险成本节约和政府支出的影响.
主要方法:
- 关于医疗保险欺诈的成功举报人诉讼的案例研究.
- 对新的法律数据的分析与大量的医疗保险索赔数据样本相结合.
- 估计通过举报人和解产生的威效应和成本节约.
主要成果:
- 据估计,19亿美元的举报人和解金创造了近19亿美元的医疗保险成本节省.
- 私人执法行动给政府带来的成本很小.
- 私人执法被证明是打击欺诈的高成本有效方法.
结论:
- 私人反欺诈执法,特别是根据"虚假索赔法"采取举报人行动,是一个成功的策略.
- 这种模式通过减少公共支出欺诈,特别是医疗保险中的欺诈,提供了显著的投资回报.
- 这些发现支持私人执法机制的持续使用和潜在扩展,以保护公共资金.
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