DOCSLIB.ORG

White Collar Crime by Health Care Providers Pamela H

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
White Collar Crime by Health Care Providers Pamela H NORTH CAROLINA LAW REVIEW Volume 67 | Number 4 Article 7 4-1-1989 Fraud by Fright: White Collar Crime by Health Care Providers Pamela H. Bucy Follow this and additional works at: http://scholarship.law.unc.edu/nclr Part of the Law Commons Recommended Citation Pamela H. Bucy, Fraud by Fright: White Collar Crime by Health Care Providers, 67 N.C. L. Rev. 855 (1989). Available at: http://scholarship.law.unc.edu/nclr/vol67/iss4/7 This Article is brought to you for free and open access by Carolina Law Scholarship Repository. It has been accepted for inclusion in North Carolina Law Review by an authorized administrator of Carolina Law Scholarship Repository. For more information, please contact [email protected]. FRAUD BY FRIGHT: WHITE COLLAR CRIME BY HEALTH CARE PROVIDERSt PAMELA H. Bucyt Fraudby health care providers is one of the most deleterious of all white collar crimes. It is also one of the most difficult to prosecute. In her Article, ProfessorBucy comparesfraud by health care providers with other types of white collar crime and analyzes the theories offraud his- torically used to prosecute health careproviders. She concludes that the strongest theory--prosecutionfor providing unnecessary or substandard health care-is the theory that has been used the least. ProfessorBucy suggests ways for prosecutors to use this theory more often and more effectively in order to combat a problem that ravishes human dignity and personal health as well as the nationalpocketbook "I will apply measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice." Portion of Oath of Hippocrates, Sixth Century B.C.- First Century A.D.; currently administered by many medical schools to graduating medical students.1 "[I c]ould make a million dollars out of the suckers ...... Statement of owner/operator of cancer clinics regarding cancer 2 patients. I knew "if sufficient testing was not done the clinic would not be profita- ble." I ordered tests that were "not medically necessary .... I prostituted my medical license." 3 Statement of physician testifying as government witness. "It [is] fantastic that on some of these patients [I] only saw them once but [I] was submitting bills and reports reflecting numerous visits and treatments." 4 Statement of physician. 0 Copyright 1989 Pamela H. Bucy. All rights reserved. t One court in finding defendant, a physician, guilty of mail fraud stated: "defendant, with the intent of fraudulent deception, meant to frighten the supposed patient into parting with his money." United States v. Smith, 222 F. 165 (E.D. Pa. 1915). t Assistant Professor of Law, University of Alabama School of Law. B.A. 1975, Austin Col- lege; J.D. 1978, Washington University School of Law; Assistant United States Attorney, E.D. Mo., Criminal Division, 1980-1987; Coordinator, Health Care Task Force, E.D. Mo. 1985-1987. The author expresses her appreciation to Dean Nathaniel Hansford for his support and encouragement; to the University of Alabama Research Grants Committee for its support; to her colleagues Wythe Holt and Kenneth C. Randall for their editorial suggestions; to Angela Aderholt, Melissa Kessler, Donna Knotts, Christopher Gerety, and Nick Whitehead for their research assistance, and to Hugh Chavern, M.D., M.P.H. and R. Pat Bucy, M.D., Ph.D for their help and insight. 1. 4 ENCYCLOPEDIA OF BIOETHICS 1731 (1978). 2. Baker v. United States, 115 F.2d 533, 540 (8th Cir. 1940), cert. denied, 312 U.S. 695 (1941). 3. United States v. Mahar, 801 F.2d 1477, 1485 (6th Cir. 1986). 4. United States v. Perez, 489 F.2d 51, 76 (5th Cir. 1973). NORTH CAROLINA LAW REVIEW [Vol. 67 Despite his altruistic admonition to physicians, Hippocrates was not naive. He also counseled new physicians that whatever houses they may visit, they should "come for the benefit of the sick, remaining free of all.., mischief." A little Hippocratic realism may be appropriate. While the vast majority of health care providers 6 are exemplary professionals, some are not. We cannot afford to ignore this fact. The cost to the public of the fraud, waste, and abuse by health care providers in the United States is an estimated $45 billion per year. 7 While criminal fraud does not account for this entire amount, criminal fraud by health care providers is a serious problem and diverts scarce health care resources.8 Moreover, because fraudulent health care providers are often incompetent health care providers, 9 the harm suffered at their hands may be more than monetary. A recent emphasis on fraud in health care by policy makers, law enforce- 5. 4 ENCYCLOPEDIA OF BIOETHICS, supra note 1, at 1731. 6. Health care providers include medical physicians, osteopathic physicians, chiropractors, podiatrists, nurses, physical and respiratory therapists, hospitals, emergicare centers, nursing homes, home nursing associations, and durable medical equipment companies. This Article does not address fraud by recipients or potential recipients of health care services as reflected in cases such as United States v. Regner, 677 F.2d 754 (9th Cir.) (insured attempted to defraud insurance company by misrepresenting facts surrounding automobile accident), cert. denied, 459 U.S. 911 (1982); United States v. Williams, 545 F.2d 47 (8th Cir. 1976) (insured failed to dis- close that he had multiple insurance policies when he applied for another policy); United States v. Pope, 415 F.2d 685 (8th Cir. 1969) (insured falsified physician statements that he submitted to insur- ance company in support of claim), cert. denied, 397 U.S. 950 (1970). 7. In 1986 $458.2 billion was spent on health care expenditures in the United States, BUREAU OF THE CENSUS, U.S. DEPT. OF COMMERCE, STATISTICAL ABSTRACT OF THE UNITED STATES 1988, at 86 (108th ed. 1988) [hereinafter STATISTICAL ABSTRACT 1988]. Many commentators fa- miliar with medical fraud estimate that ten percent of our health care costs are caused by fraud. See, e.g., Medicare andMedicaid Fraud:Hearing Before the Subcomm. on Health of the Senate Comm. on Finance,96th Cong., 2d Sess. 6 (1980) [hereinafter Medicare and Medicaid Fraud: HearingBefore Senate Comm. on Finance] (statement of Oliver B. Revell, Assistant Director, Chief of Criminal Investigative Division, Federal Bureau of Investigation); Medicare and Medicaid Fraud: Hearing Before the Subcomm. on Health & Long-Term Care of the House Select Comm. on Aging, 96th Cong., 2d Sess. 1-2 (1980) [hereinafter Medicaid and Medicare Fraud: HearingBefore House Comm. on Aging] (opening statement of Chairman Claude Pepper); Medicare and Medicaid Frauds: Hear- ing Before the Subcomm. on Health and Long-Term Care of the Senate Special Comm. on Aging, Pt. 5,94th Cong., 2d Sess. 534 (1976) [hereinafter Medicare and MedicaidFrauds: Hearing Before the Senate Comm. on Aging, Pt. 5] (statement of Frank E. Moss, D., Utah); House Select Comm. on Aging, 97th Cong., 2nd Sesm, Medicaid Fraud: A Case History in the Failureof State Enforcement III (Comm. Print 1982) [hereinafter MedicaidFraud Case History]. But see Oversight of HHS In- spector General's Effort to Combat Fraud, Waste and Abuse: Joint HearingBefore the Senate Comm. on Finance and Senate Select Comm. on Aging, 97th Cong., 1st Sess. 133 (1981) [hereinafter Over- sight]. In a 1977 report the Health and Human Services Inspector General estimated losses between $5.5 to $6.5 billion to Medicare and Medicaid that were attributable to fraud, waste, and abuse. Id. With health care expenditures in 1977 at $169.9 billion, STATISTICAL ABSTRACT 1988, supra, at 86, this estimate represents approximately three to four percent of total expenditures. This estimate, however, covers only fraud, waste, and abuse in governmental programs; it does not encompass fraud, waste, and abuse in private industry. See Oversight, supra, at 136. 8. Oversight, supra note 7, at 133. 9. See, eg., Medicare and Medicaid Frauds: Hearing Before the Senate Special Comm. on Finance, Pt. 5, supra note 7, at 525 ("[There is] rampant fraud, abuse and maladministration in the Medicaid program and a pattern of reprehensible exploitation of the sick and poor not to mention the taxpayer who is paying the bill.") (statement by Senator Charles H. Percy); Medicare & Medi- caid Frauds: Hearing Before the Subcomm. on Long-Term Care of the Senate Special Comm. on Aging, Pt 6, 94th Cong., 2d Sess. 686-87 (1976) [hereinafter Medicare and Medicaid Frauds: Hear- ing Before the Senate Comm. on Aging, Pt. 6] (statements of Nancy Kurke, M.D., staff physician at a Medicaid clinic); see infra text accompanying notes 537-57. 1989] HEALTH CARE FRAUD ment officials, and private industry1° has had dramatic ramifications for many in the health care industry. Nevertheless, the academic literature has virtually ig- nored this area of the law.1 l As one seasoned health care fraud investigator stated "[Y]ou have to have guts ....There is no body of law or procedure and you are.., going out in an area relatively unexplored."' 12 A legal synthesis and 10. Beginning in the 1970s, numerous congressional committees actively investigated fraud in health care. The Senate Committee on Aging alone held over fifty such hearings. Medicaid Fraud Case History, supra note 7, at 8-9, 14-15 nn.l-8. In response to testimony and evidence consistently indicating that the health care industry was "fraught with fraud," id. at III (remarks of Chairman Claude Pepper), Congress created an office in 1976 within the Department of Health and Human Services (HHS) vested solely with the responsibility to conduct a coordinated attack on fraud by health care providers. Pub. L. No. 94-505, 90 Stat. 2429 (1976). In 1972, 1977, 1980, 1981, 1986, and 1987 Congress passed and signed into law anti-health-care fraud and abuse bills. The 1972 Act established criminal penalties for certain types of fraud by health care providers and gave the Secre- tary of the Department of Health and Human Services (formerly HEW) authority to suspend Medi- care payments to providers found to have abused the program.
Load more

Recommended publications
  • Fraud Risk Management: a Guide to Good Practice
    Fraud risk management A guide to good practice Acknowledgements This guide is based on the fi rst edition of Fraud Risk Management: A Guide to Good Practice. The fi rst edition was prepared by a Fraud and Risk Management Working Group, which was established to look at ways of helping management accountants to be more effective in countering fraud and managing risk in their organisations. This second edition of Fraud Risk Management: A Guide to Good Practice has been updated by Helenne Doody, a specialist within CIMA Innovation and Development. Helenne specialises in Fraud Risk Management, having worked in related fi elds for the past nine years, both in the UK and other countries. Helenne also has a graduate certifi cate in Fraud Investigation through La Trobe University in Australia and a graduate certifi cate in Fraud Management through the University of Teeside in the UK. For their contributions in updating the guide to produce this second edition, CIMA would like to thank: Martin Birch FCMA, MBA Director – Finance and Information Management, Christian Aid. Roy Katzenberg Chief Financial Offi cer, RITC Syndicate Management Limited. Judy Finn Senior Lecturer, Southampton Solent University. Dr Stephen Hill E-crime and Fraud Manager, Chantrey Vellacott DFK. Richard Sharp BSc, FCMA, MBA Assistant Finance Director (Governance), Kingston Hospital NHS Trust. Allan McDonagh Managing Director, Hibis Europe Ltd. Martin Robinson and Mia Campbell on behalf of the Fraud Advisory Panel. CIMA would like also to thank those who contributed to the fi rst edition of the guide. About CIMA CIMA, the Chartered Institute of Management Accountants, is the only international accountancy body with a key focus on business.
    [Show full text]
  • Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2019
    The Department of Health and Human Services And The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2019 June 2020 TABLE OF CONTENTS I. Executive Summary 1 II. Statutory Background 3 III. Program Results and Accomplishments 5 Monetary Results 5 Expenditures 7 Overall Recoveries 8 Health Care Fraud Prevention and Enforcement Action Team 8 Health Care Fraud Prevention Partnership 10 Strike Forces 10 Opioid Fraud and Abuse Detection Unit 13 Highlights of Successful Criminal and Civil Investigations 14 IV. Department of Health and Human Services 39 Office of Inspector General 39 Centers for Medicare & Medicaid Services 61 Administration on Community Living 85 Office of the General Counsel 88 Food and Drug Administration Pharmaceutical Fraud Program 91 V. Department of Justice 95 United States Attorneys 95 Civil Division 96 Criminal Division 102 Civil Rights Division 107 Department of Justice Office of Inspector General 110 VI. Appendix 112 Federal Bureau of Investigation 112 Return on Investment Calculation 116 Total HCFAC Resources 117 VII. Glossary of Terms 118 GENERAL NOTE All years are fiscal years unless otherwise stated in the text. EXECUTIVE SUMMARY The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a national Health Care Fraud and Abuse Control Program (HCFAC or the Program) under the joint direction of the Attorney General and the Secretary of the Department of Health and Human Services (HHS),1 acting through the Inspector General, designed to coordinate federal, state and local law enforcement activities with respect to health care fraud and abuse. In its twenty-third year of operation, the Program’s continued success confirms the soundness of a collaborative approach to identify and prosecute the most egregious instances of health care fraud, to prevent future fraud and abuse, and to protect program beneficiaries.
    [Show full text]
  • Phishing and Email Spoofing
    NCUA LETTER TO CREDIT UNIONS NATIONAL CREDIT UNION ADMINISTRATION 1775 Duke Street, Alexandria, VA 22314 DATE: December 2005 LETTER NO.: 05-CU-20 TO: Federally Insured Credit Unions SUBJ: Phishing Guidance for Credit Unions And Their Members REF: Letter to Credit Unions #04-CU-12 Phishing Guidance for Credit Union Members DEAR BOARD OF DIRECTORS: In our Letter to Credit Unions #04-CU-12 Phishing Guidance for Credit Union Members, we highlighted the need to educate your membership about phishing activities. As the number and sophistication of phishing scams continues to increase, we would like to emphasize the importance of educating your employees and members on how to avoid phishing scams as well as action you and/or your members may take should they become a victim. Appendix A of this document contains information you may share with your members to help them from becoming a victim of phishing scams. Appendix B contains information you may share with your members who may have become a victim of phishing scams. Background Phishing is a form of social engineering, characterized by attempts to fraudulently acquire sensitive information, such as passwords, account, credit card details, etc. by masquerading as a trustworthy person or business in an apparently official electronic communication, such as an e-mail or an instant message. Often the message includes a warning regarding a problem related to the recipient’s account and requests the recipient to respond by following a link to a fraudulent website and providing specific confidential information. The format of the e-mail typically includes proprietary logos and branding, such as a “From” line disguised to appear as if the message came from a legitimate sender, and a link to a website or a link to an e-mail address.
    [Show full text]
  • Hot Topics in Fraud and Abuse Enforcement Involving Health Care Providers
    Hot Topics in Fraud and Abuse Enforcement Involving Health Care Providers Stephen C. Payne (moderator) Winston Y. Chan John D. W. Partridge Jonathan M. Phillips September 22, 2016 Agenda • Applicable Law • Enforcement Trends • Enforcement Theories • Recent Legal Developments • Questions 2 Applicable Law The False Claims Act (FCA) • The FCA, 31 U.S.C. §§ 3729-3733, is the federal government’s primary weapon to redress fraud against government agencies and programs. • The FCA provides for recovery of civil penalties and treble damages from any person who knowingly submits or causes the submission of false or fraudulent claims to the United States for money or property. “It seems quite clear that the objective of Congress was broadly • Under the FCA, the Attorney General, through DOJ to protect the funds attorneys, investigates and pursues FCA cases (except in and property of the declined qui tam cases). Government from fraudulent claims ….” Rainwater v. United States, 356 U.S. 590 (1958) 4 FCA – Key Provisions 31 U.S.C. Statutory Prohibition Summary § 3729(a)(1) (A) Knowingly presents, or causes to be presented, False/Fraudulent Claim a false or fraudulent claim for payment or approval (B) Knowingly makes, uses or causes to be made or False used, a false record or statement material to a Record/Statement false or fraudulent claim (C) Knowingly conceals or knowingly and improperly “Reverse” False Claim avoids or decreases an obligation to pay or transmit money or property to the Government (G) Conspires to violate a liability provision of
    [Show full text]
  • Regulation of Dietary Supplements Hearing
    S. HRG. 108–997 REGULATION OF DIETARY SUPPLEMENTS HEARING BEFORE THE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION UNITED STATES SENATE ONE HUNDRED EIGHTH CONGRESS FIRST SESSION OCTOBER 28, 2003 Printed for the use of the Committee on Commerce, Science, and Transportation ( U.S. GOVERNMENT PUBLISHING OFFICE 20–196 PDF WASHINGTON : 2016 For sale by the Superintendent of Documents, U.S. Government Publishing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Nov 24 2008 11:04 May 24, 2016 Jkt 075679 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 S:\GPO\DOCS\20196.TXT JACKIE SENATE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION ONE HUNDRED EIGHTH CONGRESS FIRST SESSION JOHN MCCAIN, Arizona, Chairman TED STEVENS, Alaska ERNEST F. HOLLINGS, South Carolina, CONRAD BURNS, Montana Ranking TRENT LOTT, Mississippi DANIEL K. INOUYE, Hawaii KAY BAILEY HUTCHISON, Texas JOHN D. ROCKEFELLER IV, West Virginia OLYMPIA J. SNOWE, Maine JOHN F. KERRY, Massachusetts SAM BROWNBACK, Kansas JOHN B. BREAUX, Louisiana GORDON SMITH, Oregon BYRON L. DORGAN, North Dakota PETER G. FITZGERALD, Illinois RON WYDEN, Oregon JOHN ENSIGN, Nevada BARBARA BOXER, California GEORGE ALLEN, Virginia BILL NELSON, Florida JOHN E. SUNUNU, New Hampshire MARIA CANTWELL, Washington FRANK R. LAUTENBERG, New Jersey JEANNE BUMPUS, Republican Staff Director and General Counsel ROBERT W. CHAMBERLIN, Republican Chief Counsel KEVIN D. KAYES, Democratic Staff Director and Chief Counsel GREGG ELIAS, Democratic General Counsel (II) VerDate Nov 24 2008 11:04 May 24, 2016 Jkt 075679 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 S:\GPO\DOCS\20196.TXT JACKIE C O N T E N T S Page Hearing held on October 28, 2003 .........................................................................
    [Show full text]
  • Task Force Initial Six Month Report
    I Initial Six-Month Report October 2016 Table of Contents Page 1 Page 2 Page 3 I. Executive Summary the Office of Inspector General for the Department of Healthcare and Family Services (“HFS-OIG”) will report $220.2 million in savings, recoupment, and avoidance in the State Medicaid program (references to Medicaid savings and recoveries include State and federal dollars). In addition, during federal FY 2015, referrals to the Illinois State Police Medicaid Fraud Control Unit (“ISP-MFCU”) led to 42 fraud convictions and $16.9 million in recoveries through criminal prosecutions, civil actions, and/or administrative referrals.4 In addition to the Medicaid program, the State of Illinois also administers insurance for over The Illinois Health Care Fraud Elimination Task 450,000 State employees, dependents, and retirees,5 and Force (the “Task Force”) is pleased to submit this six- administers the Workers’ Compensation Program for month report, detailing the Task Force’s fraud, waste, and approximately 100,000 State employees. State employee abuse identification efforts, to Governor Bruce Rauner. health insurance benefits cost Illinois taxpayers State of Illinois (“State”) government-administered approximately $3 billion on an annual basis.6 For FY health care programs provide important services to 2017, the Illinois Department of Central Management citizens and State employees. The State, however, must Services (“Illinois CMS”) estimates the liability for be ever-diligent in the administration and monitoring employee health insurance benefits to be $2.86 billion.7 of such programs in order to ensure that taxpayer funds This estimate represents a 4.1 percent growth rate from are being spent properly and in the best interest of the FY 2016 to FY 2017.8 The State’s cost per participant taxpayers.
    [Show full text]
  • Fostering Innovation to Fight Waste, Fraud, and Abuse in Health Care
    FOSTERING INNOVATION TO FIGHT WASTE, FRAUD, AND ABUSE IN HEALTH CARE HEARING BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON ENERGY AND COMMERCE HOUSE OF REPRESENTATIVES ONE HUNDRED THIRTEENTH CONGRESS FIRST SESSION FEBRUARY 27, 2013 Serial No. 113–10 ( Printed for the use of the Committee on Energy and Commerce energycommerce.house.gov U.S. GOVERNMENT PRINTING OFFICE 80–160 WASHINGTON : 2013 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Nov 24 2008 12:32 May 15, 2013 Jkt 037690 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 F:\MY DOCS\HEARINGS 113\113-10 CHRIS COMMITTEE ON ENERGY AND COMMERCE FRED UPTON, Michigan Chairman RALPH M. HALL, Texas HENRY A. WAXMAN, California JOE BARTON, Texas Ranking Member Chairman Emeritus JOHN D. DINGELL, Michigan ED WHITFIELD, Kentucky Chairman Emeritus JOHN SHIMKUS, Illinois EDWARD J. MARKEY, Massachusetts JOSEPH R. PITTS, Pennsylvania FRANK PALLONE, JR., New Jersey GREG WALDEN, Oregon BOBBY L. RUSH, Illinois LEE TERRY, Nebraska ANNA G. ESHOO, California MIKE ROGERS, Michigan ELIOT L. ENGEL, New York TIM MURPHY, Pennsylvania GENE GREEN, Texas MICHAEL C. BURGESS, Texas DIANA DEGETTE, Colorado MARSHA BLACKBURN, Tennessee LOIS CAPPS, California Vice Chairman MICHAEL F. DOYLE, Pennsylvania PHIL GINGREY, Georgia JANICE D. SCHAKOWSKY, Illinois STEVE SCALISE, Louisiana ANTHONY D. WEINER, New York ROBERT E. LATTA, Ohio JIM MATHESON, Utah CATHY MCMORRIS RODGERS, Washington G.K. BUTTERFIELD, North Carolina GREGG HARPER, Mississippi JOHN BARROW, Georgia LEONARD LANCE, New Jersey DORIS O.
    [Show full text]
  • May 20, 2019 the Topic Recent Developments No-Fault Insurance
    Background on: Insurance fraud Crime + Fraud May 20, 201 9 IN THIS ARTICLE T he t opic Recent Dev elopment s No-Fault insurance f raud Healt hcare f raud Key St at e Law s A gainst Insurance Fraud Background A ddit ional resources SHARE THIS DOWNLOAD TO PDF The topic Insurance industry estimates generally put fraud at about 10 percent of the property/casualty insurance industry’s incurred losses and loss adjustment expenses each year, although the figure can fluctuate based on line of business, economic conditions and other factors. 1 . Using this measure, over the five-year period from 2013 to 2017, property/casualty fraud amounted to about $30 billion each year. Also, the Federal Bureau of Investigation said that healthcare fraud, both private and public, is an estimated 3 to 10 percent of total healthcare expenditures. 2 Based on U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services’ data for 2010, healthcare fraud amounted to between $77 billion and $259 billion. [ ] [ ] Fraud may be committed by different parties involved in insurance transactions: applicants for insurance, policyholders, third-party claimants and professionals who provide services and equipment to claimants. Common frauds include "padding," or inflating actual claims; misrepresenting facts on an insurance application; submitting claims for injuries or damage that never occurred, services never rendered or equipment never delivered; and "staging" accidents. Forty-six states and the District of Columbia have set up fraud bureaus (some bureaus have limited powers, and some states have more than one bureau to address fraud in different lines of insurance).
    [Show full text]
  • 39 Am. Bus. LJ 575 2001-2002
    DATE DOWNLOADED: Tue Sep 28 08:09:56 2021 SOURCE: Content Downloaded from HeinOnline Citations: 39 Am. Bus. L.J. 575 2001-2002 -- Your use of this HeinOnline PDF indicates your acceptance of HeinOnline's Terms and Conditions of the license agreement available at https://hn3.giga-lib.com/HOL/License -- The search text of this PDF is generated from uncorrected OCR text. -- To obtain permission to use this article beyond the scope of your license, please use: Copyright Information E-BUYER BEWARE: WHY ONLINE AUCTION FRAUD SHOULD BE REGULATED Miriam R. Albert* INTRODUCTION Well-settled principles of law, such as those encompassing fraud in its various forms, have long maintained their vitality, adapting to changes in the legal and business environments through judicial and legislative interpretation and intervention. Many of these changes have manifested themselves in the world of commerce. The creation and development of the Internet has resulted in significant changes in the way people engage in commerce. The increasing popularity of the Internet as a medium of commerce has generated an increase in Internet fraud, raising new and challenging legal issues in areas including online auctions. Under current law, a defrauded partici- pant in an online auction transaction has no recourse against the online auction site that facilitated and controlled the auction transac- Assistant Professor of Legal and Ethical Studies, Fordham University School of Business; LL.M., New York University, 1997;J.D. and MBA, Emory University, 1987; B.A. Tufts University, 1984. The author would like to thank those who provided valuable assistance: Donna Gitter, Lisa Hone and Delores Gardner Thompson of the Federal Trade Commission, Assistant U.S.
    [Show full text]
  • Entire Issue (PDF)
    E PL UR UM IB N U U S Congressional Record United States th of America PROCEEDINGS AND DEBATES OF THE 114 CONGRESS, SECOND SESSION Vol. 162 WASHINGTON, THURSDAY, FEBRUARY 4, 2016 No. 21 House of Representatives The House met at 10 a.m. and was last day’s proceedings and announces Red, White, and Blue’s great work in called to order by the Speaker pro tem- to the House his approval thereof. enriching the lives of veterans in need. pore (Mr. MOONEY of West Virginia). Pursuant to clause 1, rule I, the Jour- I had the great privilege of knowing f nal stands approved. Ted personally and was inspired by his kindness, his humor, and his love for DESIGNATION OF THE SPEAKER f his family and country. Ted will al- PRO TEMPORE PLEDGE OF ALLEGIANCE ways be remembered as an honorable The SPEAKER pro tempore laid be- The SPEAKER pro tempore. Will the young man who touched many lives, fore the House the following commu- gentlewoman from New York (Ms. having a lasting positive impact on all nication from the Speaker: STEFANIK) come forward and lead the who knew and loved him. WASHINGTON, DC, House in the Pledge of Allegiance. May his name forever be remembered February 4, 2016. Ms. STEFANIK led the Pledge of Al- in the CONGRESSIONAL RECORD and in I hereby appoint the Honorable ALEXANDER legiance as follows: the great United States of America. X. MOONEY to act as Speaker pro tempore on this day. I pledge allegiance to the Flag of the United States of America, and to the Repub- f PAUL D.
    [Show full text]
  • Unconventional Cancer Treatments
    Unconventional Cancer Treatments September 1990 OTA-H-405 NTIS order #PB91-104893 Recommended Citation: U.S. Congress, Office of Technology Assessment, Unconventional Cancer Treatments, OTA-H-405 (Washington, DC: U.S. Government Printing Office, September 1990). For sale by the Superintendent of Documents U.S. Government Printing OffIce, Washington, DC 20402-9325 (order form can be found in the back of this report) Foreword A diagnosis of cancer can transform abruptly the lives of patients and those around them, as individuals attempt to cope with the changed circumstances of their lives and the strong emotions evoked by the disease. While mainstream medicine can improve the prospects for long-term survival for about half of the approximately one million Americans diagnosed with cancer each year, the rest will die of their disease within a few years. There remains a degree of uncertainty and desperation associated with “facing the odds” in cancer treatment. To thousands of patients, mainstream medicine’s role in cancer treatment is not sufficient. Instead, they seek to supplement or supplant conventional cancer treatments with a variety of treatments that exist outside, at varying distances from, the bounds of mainstream medical research and practice. The range is broad—from supportive psychological approaches used as adjuncts to standard treatments, to a variety of practices that reject the norms of mainstream medical practice. To many patients, the attractiveness of such unconventional cancer treatments may stem in part from the acknowledged inadequacies of current medically-accepted treatments, and from the too frequent inattention of mainstream medical research and practice to the wider dimensions of a cancer patient’s concerns.
    [Show full text]
  • Medicare Fraud and Improper Billing
    Medicare Fraud and Improper Billing ISSUE BRIEF • July 2018 Part I. Medicare Fraud Prevention Micki Nozaki, Director, California Health Advocates, Senior Medicare Patrol California Health Advocates Founded in 1997, California Health Advocates (CHA) is the leading Medicare advocacy and education non-profit in California. We advocate on behalf of Medicare beneficiaries and their families; conduct public policy research to support improved rights and protections for Medicare beneficiaries; and provide accurate and up-to-date Medicare information for both Medicare beneficiaries and their families as well as the advocates and providers who serve them. Senior Medicare Patrol The California Senior Medicare Patrol (SMP) is a project under CHA. We empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report healthcare fraud, errors and abuse through: (1) Education: SMPs give presentations to groups, exhibit at events and work one-on-one with Medicare beneficiaries; (2) Counseling: SMPs work to protect older adults’ health, finances and medical identity while saving precious Medicare dollars; and (3) Assisting Medicare beneficiaries, caregivers and family members when they bring their concerns or complaints to the SMP. We determine whether fraud, errors, or abuse are suspected. When fraud or abuse is assumed, we make referrals to the appropriate state and federal agencies for further investigation. There are 54 Senior Medicare Patrol (SMP) programs throughout the country. SMPs are grant-funded projects of the federal U.S. Department of Health and Human Services, Administration for Community Living. Key Lessons 1. The Medicare Trust Fund loses $60–$90 billion every year to fraud, errors, and abuse.Although the exact figure is impossible to measure, the U.S.
    [Show full text]