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A Patient-Centered Approach to Health Care Fraud Recovery

43 Pages Posted: 30 Jun 2006  

Joan H. Krause

University of North Carolina (UNC) at Chapel Hill - School of Law

Abstract

This article addresses the disposition of proceeds from health care fraud settlements and explores mechanisms to direct some portion of those proceeds to injured patients. Currently, funds recovered through health care fraud enforcement are distributed to the Medicare Trust Fund, to the investigating federal agencies, and to private parties who initiate suits on the government's behalf under the civil False Claims Act - but rarely to patients who have been harmed by the conduct. While returning funds to the federal Treasury helps to assure that the federal health care programs remain solvent, it does not directly benefit injured individuals. Moreover, this approach stands in marked contrast to recent efforts to make the United States health care system more "patient-centered." After analyzing the conceptual framework of this system, the article outlines recent examples of more consumer-oriented health care fraud settlements and explores whether common consumer protection compensation strategies might be adopted more broadly in the health care fraud context.

Suggested Citation

Krause, Joan H., A Patient-Centered Approach to Health Care Fraud Recovery. Journal of Criminal Law & Criminology, Vol. 96, p. 579, 2006; U of Houston Law Center No. 2006-A-15. Available at SSRN: https://ssrn.com/abstract=913049

Joan H. Krause (Contact Author)

University of North Carolina (UNC) at Chapel Hill - School of Law ( email )

Van Hecke-Wettach Hall, 160 Ridge Road
CB #3380
Chapel Hill, NC 27599-3380
United States
919-962-4126 (Phone)
919-962-1277 (Fax)

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