医疗保健欺诈和护理质量:以患者为中心的方法。

Journal of health law Pub Date : 2004-01-01
Joan H Krause
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引用次数: 0

摘要

本文通过检查与质量相关的欺诈解决方案在多大程度上有利于患者,探讨了护理质量和医疗保健欺诈之间的交集。提交人认为,尽管联邦政府经常援引保护受益人的健康和福利作为开展反欺诈工作的理由之一,但在许多谈判达成的解决方案中,这种考虑似乎没有发挥很大作用。虽然将资金返还给联邦财政部有助于确保联邦医疗保健计划保持偿付能力,并继续为总体受益者服务,但它可能无法充分解决对个别患者的伤害。因此,作者得出结论,现在可能是时候探索新的欺诈解决模式,可以为可能遭受伤害的患者提供足够的赔偿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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Healthcare fraud and quality of care: a patient-centered approach.

This Article explores the intersection between quality of care and healthcare fraud by examining the extent to which quality-related fraud settlements benefit patients. The author argues that, although the protection of beneficiary health and welfare often is invoked by the federal government as one of the reasons for undertaking anti-fraud efforts, such considerations do not appear to play a large role in many of the settlements that are negotiated. While returning funds to the federal Treasury helps to ensure that the federal healthcare programs remain solvent and continue to serve beneficiaries in the aggregate, it may not adequately address harm to individual patients. Thus, the author concludes it may be time to explore new models of fraud settlements that can provide adequate compensation to the patients who may have suffered harm.

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