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Article
Publication date: 23 June 2020

Nicole F. Stowell, Carl Pacini, Martina K. Schmidt and Nathan Wadlinger

This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent…

Abstract

Purpose

This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud.

Design/methodology/approach

This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws.

Findings

The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come.

Research limitations/implications

Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors.

Practical implications

Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers.

Originality/value

This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.

Article
Publication date: 1 October 2018

Nicole F. Stowell, Martina Schmidt and Nathan Wadlinger

The purpose of this paper is to make readers aware of the extensiveness of healthcare fraud in the USA and how it involves and affects the government, healthcare providers…

1811

Abstract

Purpose

The purpose of this paper is to make readers aware of the extensiveness of healthcare fraud in the USA and how it involves and affects the government, healthcare providers, insurance companies, patients and the public. In addition, recommendations are made that may help control this pervasive type of fraud.

Design/methodology/approach

A range of different journal publications, information from government health institutions and law enforcement websites, healthcare fraud cases and healthcare laws are used as a basis to provide information about how fraudsters are committing healthcare fraud and how to prevent this fraud from occurring.

Findings

Despite increased funding and prosecution efforts by the government, healthcare fraud continues to be a major threat to the US economy and public. While healthcare fraud will never be eradicated, specific efforts can be deployed to help rein in these complex fraud schemes.

Practical implications

The paper provides a useful resource of information on healthcare fraud for healthcare providers, insurance companies, patients and the public that may help combat healthcare fraud and prevent financial losses.

Social implications

Every dollar saved from combating fraud could be used to improve access to more or better health services and can, thereby, save lives.

Originality/value

This paper provides recommendations regarding healthcare fraud that could help prevent this large drain on the US economy.

Details

Journal of Financial Crime, vol. 25 no. 4
Type: Research Article
ISSN: 1359-0790

Keywords

Article
Publication date: 7 February 2014

Mohamed Chelli, Sylvain Durocher and Jacques Richard

The paper seeks to adopt an institutional view of legitimacy to examine how a sample of French companies reacted to the introduction of the “New Economic Regulations” in French law

4542

Abstract

Purpose

The paper seeks to adopt an institutional view of legitimacy to examine how a sample of French companies reacted to the introduction of the “New Economic Regulations” in French law in 2001 requiring that publicly listed companies disclose environmental information.

Design/methodology/approach

The approach used in the paper is both quantitative and qualitative. A content analysis of environmental disclosure provided in annual reports, environmental reports and web sites by 26 French companies listed in the CAC 40 is performed throughout the period 2001-2011.

Findings

The findings of this study show a significant and enduring improvement in the quality and quantity of environmental disclosure from 2001 to 2011. Even in the absence of penalties for non-compliance, the NRE law stimulated a stark and positive lasting change in the way that French companies account for their environmental information. These findings are consistent with the institutional view of legitimacy theory whereby legislation provides corporate managers with a representation of relevant audiences' perceptions about social and environmental reporting, prompting them to comply with the law to ensure organizational legitimacy.

Originality/value

Social and environmental reporting studies generally adopt a strategic view of legitimacy to examine how organizations use social and environmental reporting to respond strategically to legitimacy threats. This study provides early empirical evidence about the relevance of institutional legitimacy theory in explaining environmental reporting.

Details

Accounting, Auditing & Accountability Journal, vol. 27 no. 2
Type: Research Article
ISSN: 0951-3574

Keywords

Book part
Publication date: 11 August 2014

Mona Al-Amin, Robert Weech-Maldonado and Rohit Pradhan

The hospital–physician relationship (HPR) has been the focus of many scholars given the potential impact of this relationship on hospitals’ ability to achieve socially and…

Abstract

Purpose

The hospital–physician relationship (HPR) has been the focus of many scholars given the potential impact of this relationship on hospitals’ ability to achieve socially and organizationally desirable health care outcomes. Hospitals are dominated by professionals and share many commonalities with professional service firms (PSFs). In this chapter, we explore an alternative HPR based on the governance models prevalent in PSFs.

Design/methodology approach

We summarize the issues presented by current HPRs and discuss the governance models dominant in PSFs.

Findings

We identify the non-equity partnership model as a governance archetype for hospitals; this model accounts for both the professional dominance in health care decisions and the increasing demand for higher accountability and efficiency.

Research limitations

There should be careful consideration of existing regulations such as the Stark law and the antikickback statue before the proposed governance model and the compensation structure for physician partners is adopted.

Research implications

While our governance archetype is based on a review of the literature on HPRs and PSFs, further research is needed to test our model.

Practical implications

Given the dominance of not-for-profit (NFP) ownership in the hospital industry, we believe the non-equity partnership model can help align physician incentives with those of the hospital, and strengthen HPRs to meet the demands of the changing health care environment.

Originality/value

This is the first chapter to explore an alternative hospital–physician integration strategy by examining the governance models in PSFs, which similar to hospitals have a high reliance on a predominantly professional staff.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

Keywords

Book part
Publication date: 22 December 2008

Peter Robson

Just as the films that we see are conceived in specific economic, political and cultural contexts, so scholarship is produced within determined situations. This chapter notes some…

Abstract

Just as the films that we see are conceived in specific economic, political and cultural contexts, so scholarship is produced within determined situations. This chapter notes some of the driving forces which have led to the emergence of law and film as an area of extensive and very diverse scholarship in the past decade. Whilst these factors have shaped the nature and extent of this work it should be noted that changes in both legal professional interests, academic criteria and within the culture industry mean that we can expect shifts in the nature and patterns of scholarship in the future. These may not, however, be the ones called for by other commentators (Moran, Sandon, Loizidou, & Christie, 2004; Sarat, Douglas, & Umphrey, 2005).

Details

Studies in Law, Politics and Society
Type: Book
ISBN: 978-1-84855-378-1

Book part
Publication date: 2 December 2013

Seth Abrutyn

A synthesis of the various strands of macro-sociology that is commensurate with a more robust theory of evolutionary institutionalism.

Abstract

Purpose

A synthesis of the various strands of macro-sociology that is commensurate with a more robust theory of evolutionary institutionalism.

Design/methodology/approach

Drawing from what may be conceived of as classical institutionalism and from neo-evolutionary sociology and other related traditions, this chapter endeavors to provide a general theory of evolutionary institutionalism as an overview of institutions and institutional autonomy (along with the underlying forces driving the process of autonomy), to present a theory of institutional evolution that delineates the relevant units of selection and evolution, the types of mechanisms that facilitate institutional evolution, and a typology of the sources of variation.

Findings

The chapter constitutes the attempt to provide a theoretical framework intended to engender an improved historical-comparative institutionalism inspired by the works of Max Weber and Herbert Spencer.

Research limitations/implications

The purpose of the theoretical framework presented should not be misconstrued as a general, “grand” theory for the discipline of the sociology as a whole, but rather understood as the model of a common vocabulary for sociologists interested in macro-sociology, institutions, and socio-cultural evolution designed to complement other available models.

Originality/value

As a synthesis, the originality of the theoretical framework presented lies in (1) elucidation of the idea that institutional autonomy as the “master” process of institutional evolution, (2) more precise delineation of the link between meso-level institutional entrepreneurs and institutional evolution, and (3) combination of a body of complementary – yet often loosely linked – bodies of scholarship.

Details

Social Theories of History and Histories of Social Theory
Type: Book
ISBN: 978-1-78350-219-6

Keywords

Open Access
Article
Publication date: 13 October 2023

Roland Hellberg

A deteriorating security situation and an increased need for defence equipment calls for new forms of collaboration between Armed Forces and the defence industry. This paper aims…

1072

Abstract

Purpose

A deteriorating security situation and an increased need for defence equipment calls for new forms of collaboration between Armed Forces and the defence industry. This paper aims to investigate the ways in which the accelerating demand for increased security of supply of equipment and supplies to the Armed Forces requires adaptability in the procurement process that is governed by laws on public procurement (PP).

Design/methodology/approach

This paper is based on a review of current literature as well as empirical data obtained through interviews with representatives from the Swedish Defence Materiel Administration and the Swedish defence industry.

Findings

Collaboration with the globalized defence industry requires new approaches, where the PP rules make procurement of a safe supply of defence equipment difficult.

Research limitations/implications

The study's empirical data and findings are based on the Swedish context. In order to draw more general conclusions in a defence context, the study should be expanded to cover more nations.

Practical implications

The findings will enable the defence industry and the procurement authorizations to better understand the requirements of Armed Forces, and how to cooperate under applicable legal and regulatory requirements.

Originality/value

The paper extends the extant body of academic knowledge of the security of supply into the defence sector. It serves as a first step towards articulating a call for new approaches to collaboration in defence supply chains.

Details

Journal of Defense Analytics and Logistics, vol. 7 no. 2
Type: Research Article
ISSN: 2399-6439

Keywords

Book part
Publication date: 16 September 2022

Katerina Toshevska-Trpchevska, Irena Kikerkova, Elena Makrevska Disoska and Ljuben Kocev

Trade in counterfeit products has been expanding continuously. The emergence of the internet, the process of globalisation as well as the increase of digitalisation have enabled…

Abstract

Trade in counterfeit products has been expanding continuously. The emergence of the internet, the process of globalisation as well as the increase of digitalisation have enabled counterfeit products to infiltrate legitimate supply chains, causing harm not only to national economies but also to holders of intellectual property rights (IPR). In this chapter, we analyse the possible solutions that holders of IP rights and their legal representatives have in their fight against the online sale of counterfeit products. To elaborate on this issue, first, we explain the legislation on an international level for IPR protection and its specific characteristics. We explain the conventions on the protection of IPR that are governed by the World Intellectual Protection Organisation (WIPO) and the provisions of the TRIPS (Trade-Related Intellectual Property Rights) Agreement governed by the World Trade Organisation (WTO). We also analyse the national legislative procedure of protecting and enforcing IPR in North Macedonia to explain a possible solution to fight online counterfeit trade. As a case study of this chapter, we explain the work of the Online Enforcement Programme of REACT as a not-for-profit organisation with over 30 years of experience in the fight against counterfeit trade and the challenges that they have in fighting against the online sale of counterfeit products. Since IP law is territorial in its nature as a conclusion, we suggest that a more centralised approach is needed in the fight against the online sale of counterfeit products.

Details

Counterfeiting and Fraud in Supply Chains
Type: Book
ISBN: 978-1-80117-574-6

Keywords

Abstract

Details

Making Sense of Ultra-Realism
Type: Book
ISBN: 978-1-80117-170-0

Book part
Publication date: 10 July 2019

Marilena Chrysanthakopoulou

The Belt and Road Initiative (BRI) is endeavor of paramount importance that is likely to redefine socio-economic relations in countries and regions concerned. The debate on BRI’s…

Abstract

The Belt and Road Initiative (BRI) is endeavor of paramount importance that is likely to redefine socio-economic relations in countries and regions concerned. The debate on BRI’s relevance, scope, and potential has only begun, and it remains uncertain how exactly it will unfold. In this context, questions pertinent to regulatory frameworks in the context of which BRI initiatives are implemented belong to the most complex and the most interesting ones. Due to BRI’s novelty and open-endedness, all matters pertaining to its implementation are of exploratory nature; especially the legal aspects of its implementation. This aim of this chapter is to provide insightful answers to legal questions regarding BRI and dispute resolution via the examination of the current legal status of BRI, as well as explore how trust and cultural awareness can contribute to the avoidance of business-related disputes.

Details

The New Silk Road Leads through the Arab Peninsula: Mastering Global Business and Innovation
Type: Book
ISBN: 978-1-78756-680-4

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