Problem

Misconduct of medical executives

Other Names:
Hospital fraud
Health 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.

Problem Type:
G: Very specific problems
Related UN Sustainable Development Goals:
GOAL 1: No PovertyGOAL 3: Good Health and Well-being
Date of last update
21.05.1999 – 00:00 CEST