Ambulance Taxis: The Impact of Regulation and Litigation on Health-Care Fraud

• 成果类型: Article
• 署名作者: Eliason, Paul; League, Riley; Leder-Luis, Jetson; Mcdevitt, Ryan C.; Roberts, James W.
• 署名单位: Utah System of Higher Education; University of Utah; National Bureau of Economic Research; University of Illinois System; University of Illinois Urbana-Champaign; Boston University; Duke University
• 刊物名称: JOURNAL OF POLITICAL ECONOMY
• ISSN/ISSBN: 0022-3808
• DOI: 10.1086/734134
• 发表日期: 2025
• 页码: 1661-1702
• 关键词: enforcement

摘要

We study the effectiveness of pay-and-chase lawsuits and up-front regulations for combating health-care fraud. Between 2003 and 2017, Medicare spent $7.7 billion on 37.5 million regularly scheduled ambulance rides for patients traveling to and from dialysis facilities even though many did not satisfy Medicare's criteria for receiving reimbursements. Using an identification strategy based on the staggered timing of regulations and lawsuits across the United States, we find that adding a prior authorization requirement for ambulance reimbursements reduced spending much more than pursuing criminal and civil litigation did on their own. We find no evidence that prior authorization affected patients' health.