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Toward A Fair And Practical Definition Of "Willfully" In The Medicare/Medicaid Anti-Kickback Statute, Tamsen D. Love
Toward A Fair And Practical Definition Of "Willfully" In The Medicare/Medicaid Anti-Kickback Statute, Tamsen D. Love
Vanderbilt Law Review
Health care fraud takes on a variety of forms-from billing insurance companies for services not provided, to falsifying injuries for tort plaintiffs, to practicing medicine without a license.' All these types of fraud contribute to the astronomical cost of health care in the United States. As federal policymakers have focused on ways to contain these costs, health care fraud has become an increasing object of scrutiny. At the same time, the health care industry is experiencing significant institutional change, particularly with the emergence of health maintenance organizations ("HMOs") and other managed care systems. The Medicare/Medicaid anti-kickback statute, which prohibits payments …
Recent Developments, Mark J. Mathiesen
Recent Developments, Mark J. Mathiesen
Vanderbilt Law Review
Under the existing statute Congress has attempted by legislation to encourage the development of HMOs as a viable alternative for the health-care consumer. As is often the casein the political world of Congress, the fanfare accompanying a legislative response has obscured the deficiencies of the answer. This act with its limited appropriations, restricted preemption language,and failure to support profit-making HMOs constitutes an experimental approach to the HMO concept, and therefore, only illusionary support for its development.