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reimbursed by insurers. A major concern in this system is overbilling, waste and fraud by providers, who face incentives to … providers that overbill insurers. Using large-scale claims data from Medicare, the US federal health insurance program for … elderly adults and the disabled, we identify patterns consistent with fraud or overbilling among inpatient hospitalizations …
Persistent link: https://www.econbiz.de/10014226143
What external control mechanisms are most effective in detecting corporate fraud? To address this question we study in … depth all reported cases of corporate fraud in companies with more than 750 million dollars in assets between 1996 and 2004 …. We find that fraud detection does not rely on one single mechanism, but on a wide range of, often improbable, actors …
Persistent link: https://www.econbiz.de/10012465774
We show that firms with CEOs who personally benefitted from options backdating were more likely to engage in other forms of corporate misbehavior, suggestive of an unethical corporate culture. These firms were more likely to overstate firm profitability and to engage in less profitable...
Persistent link: https://www.econbiz.de/10012459399
When we take a cab we may feel cheated if the driver takes an unnecessarily long route despite the lack of a contract or promise to take the shortest possible path. Is our decision to take the cab affected by our belief that we may end up feeling cheated? Is the behavior of the driver affected...
Persistent link: https://www.econbiz.de/10012460152
Transparency is usually thought to reduce favoritism and corruption by facilitating monitoring by outsiders, but there is concern it can have the perverse effect of facilitating collusion by insiders. In response to vote trading scandals in the 1998 and 2002 Olympics, the International Skating...
Persistent link: https://www.econbiz.de/10012460925
Some states that have not adopted the Affordable Care Act (ACA) Medicaid expansions have stated concerns that the expansions may impair access to care and utilization for those who are already insured. We investigate such negative spillovers using a large panel of Medicare beneficiaries. Across...
Persistent link: https://www.econbiz.de/10012480805
One unusual feature of the U.S. property-casualty insurance industry is the coexistence of stock and mutual companies … insurance companies respond to differences in their underwriting environment. Agency theories suggest that the stock company may …' performance, by state and by line, in eight different lines of insurance. Stock companies are more likely than mutuals to reduce …
Persistent link: https://www.econbiz.de/10012473629
In this paper we explore the conjecture that the periodic episodes of high prices and constrained supply in the property- casualty industry are the result of temporary capital shortages. We do this by looking for increases in activities aimed at increasing capital at these times: dividend cuts,...
Persistent link: https://www.econbiz.de/10012473648
Care Act (ACA)'s Health Insurance Marketplaces. The RC program, which was defunded ahead of coverage year 2016, and ended … defunding, had greater premium increases in 2017, after the program ended. Insurance markets in which more insurers made RC …
Persistent link: https://www.econbiz.de/10012453585
the seemingly failure of the private insurance market to provide coverage for terrorism losses after the attack on … government provision of terrorism insurance. The paper argues that mostly unfettered insurance and capital markets are capable of …
Persistent link: https://www.econbiz.de/10012467649