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When the first edition of Degree Mills was published, fake universities and counterfeit degrees were already a significant problem. Fueled by the Internet, this scam continues to grow—now more than half of all people claiming a new PhD in fact have a fake degree. In this updated edition, experts Allen Ezell and John Bear go beyond exposing these fraudulent practices to provide detailed recommendations—for government agencies, educational institutions, and individuals—on what can be done to rid us of them. This eye-opening and definitive guide shows how degree mills operate and how to check the validity of anyone’s degree—an indispensable reference book.
Confronting medical fraud and its economic, psychological, and social costs.
Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
The New England Journal of Medicine is one of the most important general medical journals in the world. Doctors rely on the conclusions it publishes, and most do not have the time to look beyond abstracts to examine methodology or question assumptions. Many of its pronouncements are conveyed by the media to a mass audience, which is likely to take them as authoritative. But is this trust entirely warranted? Theodore Dalrymple, a doctor retired from practice, turned a critical eye upon a full year of the Journal, alert to dubious premises and to what is left unsaid. In False Positive, he demonstrates that many of the papers it publishes reach conclusions that are not only flawed, but obviously flawed. He exposes errors of reasoning and conspicuous omissions apparently undetected by the editors. In some cases, there is reason to suspect actual corruption. When the Journal takes on social questions, its perspective is solidly politically correct. Practically no debate on social issues appears in the printed version, and highly debatable points of view go unchallenged. The Journal reads as if there were only one possible point of view, though the American medical profession (to say nothing of the extensive foreign readership) cannot possibly be in total agreement with the stances taken in its pages. It is thus more megaphone than sounding board. There is indeed much in the New England Journal of Medicine that deserves praise and admiration. But this book should encourage the general reader to take a constructively critical view of medical news and to be wary of the latest medical doctrines.
“A mosaic mystery told in vignettes, cliffhangers, curious asides, and some surreal plot twists as Raffel investigates the secrets of the man who changed infant care in America.”—NPR, 2018's Great Reads What kind of doctor puts his patients on display? This is the spellbinding tale of a mysterious Coney Island doctor who revolutionized neonatal care more than one hundred years ago and saved some seven thousand babies. Dr. Martin Couney's story is a kaleidoscopic ride through the intersection of ebullient entrepreneurship, enlightened pediatric care, and the wild culture of world's fairs at the beginning of the American Century. As Dawn Raffel recounts, Dr. Couney used incubators and careful nursing to keep previously doomed infants alive, while displaying these babies alongside sword swallowers, bearded ladies, and burlesque shows at Coney Island, Atlantic City, and venues across the nation. How this turn-of-the-twentieth-century émigré became the savior to families with premature infants—known then as “weaklings”—as he ignored the scorn of the medical establishment and fought the rising popularity of eugenics is one of the most astounding stories of modern medicine. Dr. Couney, for all his entrepreneurial gusto, is a surprisingly appealing character, someone who genuinely cared for the well-being of his tiny patients. But he had something to hide... Drawing on historical documents, original reportage, and interviews with surviving patients, Dawn Raffel tells the marvelously eccentric story of Couney's mysterious carnival career, his larger-than-life personality, and his unprecedented success as the savior of the fragile wonders that are tiny, tiny babies. A New York Times Book Review New & Noteworthy Title A Real Simple Best Book of 2018 Christopher Award-winner
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Includes section "Books and reports."