Problem
Misconduct of medical executives
Other Names:
Hospital fraudHealth care fraud
Medical service fraud
Nature:
The management in hospitals can defraud its sponsors, for example, the government or insurance agencies, by submitting claims for unrealized costs. A psychiatric hospital can bribe doctors to give it patient referrals, including referrals for patients who are not in fact ill. Then the insurance companies must pay for unnecessary treatment. Incidence:
In 1997, 3 American hospital executives were indicted for submitting fraudulent expense reports on behalf of their hospital to the goverment for reimbursement. A previous governmental report claimed that more than $50 million worth of fraudulent claims were received per year.In 1995, the British national health service uncovered 960 fraudulent claims worth £6 million over the previous 3 years. Two agencies had submitted bills to the NHS for services that had not in fact been performed or hours not worked and phantom doctors.
Broader Problems:
Misuse of public health fundsInappropriate managed care regimesUnethical practices of health services Strategies:
Improving communication within companiesInforming about fraudReporting malpractice by service companies Values:
CareHealthServiceFraudMisconduct Subject(s):
Medicine → Medicine Social Activity → Executives, supervisors
Social Activity → Services
Societal Problems → Crime
Health Care → Hospitals
Health Care → Care
Related UN Sustainable Development Goals:
Problem Type:
G: Very specific problems Date of last update
21.05.1999 – 00:00 CEST