An Investigation of Fraud Mitigating Factors in Not-For-Profit Hospitals

• In Event: 3.02 Government Research Concurrent Session: Healthcare (Gov't & NPO) & Other - Cases

Abstract

We are the first to investigate actual Medicare/Medicaid fraud claims in the Not-for-profit hospital setting using panel data. We collect data from a Freedom of Information Act (FOIA) request made to the Center of Medicare and Medicaid Statistics (CMS) for The United States Justice Department’s fraud statistics. We combine this data with IRS, OMB, and OPDR data. We are able to identify the utility of governance and oversight mechanisms using real fraud claims data. Our results indicate that oversight and corporate governance measures can help mitigate fraud.

Authors

• Benedikt Markus Quosigk, Kennesaw State University

• Jomon Paul, Kennesaw State University