举报人能否根除公共支出欺诈?来自医疗保险的证据
Can Whistleblowers Root Out Public Expenditure Fraud? Evidence from Medicare
Review of Economics and Statistics · 2023 · [{"name": "Jetson Leder-Luis", "affiliation": ["Boston University", "Quest University Canada"]}]
中文摘要
本文分析了《虚假申报法》下的私人反欺诈执法，该法对起诉向美国政府超额收费的医疗服务提供者的举报人给予补偿。我对若干涉及Medicare欺诈的成功举报人诉讼进行了案例研究，将新的法律数据与大样本Medicare理赔数据进行匹配。我估计，19亿美元举报人和解金所产生的威慑效应，为Medicare带来了近190亿美元的成本节约，同时给政府带来的成本较低。这些结果表明，私人执法是打击公共支出欺诈的一种具有成本效益的方式。
Abstract
This paper analyzes private anti-fraud enforcement under the False Claims Act, which compensates whistleblowers for litigating against healthcare providers who overbill the US government. I conduct several case studies of successful whistleblower lawsuits concerning Medicare fraud, pairing new legal data with large samples of Medicare claims. I estimate that deterrence from $1.9 billion in whistleblower settlements generated Medicare cost savings of nearly $19 billion, while imposing low costs on the government. These results suggest private enforcement is a cost-effective way to combat public expenditure fraud.