Prescription for Profit - How Doctors Defraud Medicaid (Hardcover)

This expose of the US health care system uncovers the dark side of physician practice. Using interviews with doctors and federal, state and private officials, it reveals the practices of doctors who profit from abortions on women who are not pregnant, of needless surgery, overcharging for services and excessive testing. The authors trace patterns of abuse to the inauguration of the American Medicaid programme in the mid 1960s, when government authorities, not individual patients, were entrusted with responsibility for payments. Determining fees and regulating treatment also became the job of government agencies, thus limiting the doctors' traditional role. Physicians continue to disagree with Medicare and Medicaid policies that infringe on their autonomy and judgement. The medical profession has not accepted the gravity or extent of some members' illegal behaviour, and individual doctors continue to blame violations on subordinates and patients. In the meantime, programme guidelines have grown more confusing, blocking efforts to detect, apprehend and prosecute Medicaid defrauders. Failure to institute a coherent policy for fraud control in the medical benefit programme, the authors