دورية أكاديمية
Health Care Fraud and Abuse: Lessons From One of the Largest Scandals of the 21st Century in the Field of Spine Surgery.
| العنوان: | Health Care Fraud and Abuse: Lessons From One of the Largest Scandals of the 21st Century in the Field of Spine Surgery. |
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| المؤلفون: | Szewczyk T; From the Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO., Sinha MS; Center for Health Law Studies, Saint Louis University School of Law, Saint Louis, MO., Gerling J; From the Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO., Zhang JK; From the Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO.; Department of Neurosurgery, University of Utah, Salt Lake City, UT., Mercier P; From the Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO., Mattei TA; From the Division of Neurological Surgery, Saint Louis University School of Medicine, Saint Louis, MO. |
| المصدر: | Annals of surgery open : perspectives of surgical history, education, and clinical approaches [Ann Surg Open] 2024 Jun 18; Vol. 5 (2), pp. e452. Date of Electronic Publication: 2024 Jun 18 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 101769928 Publication Model: eCollection Cited Medium: Internet ISSN: 2691-3593 (Electronic) Linking ISSN: 26913593 NLM ISO Abbreviation: Ann Surg Open Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Wolters Kluwer, [2020]- |
| مستخلص: | Up to hundreds of billions of dollars are annually lost to fraud and abuse in the US health care, making it a significant burden on the system. This study investigates a specific instance of health care fraud in spine surgery, in which a medical device company ended up paying $75 million to settle violations of the False Claims Act. We review the surgical background regarding the kyphoplasty procedure, as well as its billing and reimbursement details. We also explore the official legal complaint brought by the US Department of Justice to tell the story of how one of the most significant medical innovations in spine surgery in the 21st century turned into a widespread fraudulent marketing scheme. In the sequence, we provide a detailed root cause analysis of this scandal and propose some proactive measures that can be taken to avoid such type of unfortunate events. Ultimately, this historical health care scandal constitutes a valuable lesson to surgeons, health care administrators, medical device companies, and policymakers on how misaligned incentives and subsequent unscrupulous practices can transform a medical innovation into an unfortunate tale of fraud and deceit. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.) |
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| فهرسة مساهمة: | Keywords: False Claims Act; Food and Drug Administration; healthcare fraud; kyphoplasty; spine surgery; surgical innovation |
| تواريخ الأحداث: | Date Created: 20240624 Latest Revision: 20240625 |
| رمز التحديث: | 20240625 |
| مُعرف محوري في PubMed: | PMC11191893 |
| DOI: | 10.1097/AS9.0000000000000452 |
| PMID: | 38911625 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2691-3593 |
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| DOI: | 10.1097/AS9.0000000000000452 |