Investigators from University of California San Francisco (UCSF) Have Reported New Data on Insurance (Legislating Medicare Fraud: the Politics of Self-regulation and the Creation of Professional Standards Review Organizations): Insurance

2022 SEP 29 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Data detailed on Insurance have been presented. According to news reporting from San Francisco, California, by NewsRx journalists, research stated, “Not long after the 1966 enactment of Medicare and Medicaid, evidence emerged that unscrupulous physicians and health care organizations were gaming the system. Research over the past 50 years shows that around 10 percent of the federal government’s annual cost for these programs is attributed to fraudulent claims or abuses where hospitals and treatments have been overused for undue provider profit.”

The news correspondents obtained a quote from the research from the University of California San Francisco (UCSF), “This article examines early congressional attention to this problem and describes lawmakers’ attempts to find legislative solutions to it. It historicizes the dilemma of balancing the ideological limits of government regulation with cultural assumptions about professional self-regulation, focusing on a major 1972 law, the Professional Standards Review Organization (PSRO) Act. The law launched a 10-year career for PSROs, physician-staffed peer-review boards designed to identify and sanction efforts to overcharge Medicare.”

According to the news reporters, the research concluded: “The article contextualizes multiple actors’ concerns over cost containment and the crisis of faith in medical authority that persisted following failures to control professional malfeasance.”

This research has been peer-reviewed.

For more information on this research see: Legislating Medicare Fraud: the Politics of Self-regulation and the Creation of Professional Standards Review Organizations. Journal of Policy History, 2022;34(4):475-504. Journal of Policy History can be contacted at: Cambridge Univ Press, 32 Avenue Of The Americas, New York, NY 10013-2473, USA. (Cambridge University Press - www.cambridge.org; Journal of Policy History - http://journals.cambridge.org/action/displayJournal?jid=JPH)

Our news journalists report that additional information may be obtained by contacting Brian Dolan, University of California San Francisco (UCSF), Hist Hlth Sci, San Francisco, CA 94143, United States.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1017/s0898030622000173. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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