138 research outputs found
Preventing fraud and providing services: The private healthcare insurance sector
The private healthcare insurance sector is rarely the subject of criminological analysis unless seen as corrupt. It is even more unusual that it is the subject of analysis as a victim of fraud. This paper is thus different in that it establishes a picture of international private healthcare insurance sectors approach in preventing fraud and providing healthcare services. We start by explaining why the private health insurance markets exist. This is followed by the methods employed to secure innovative data from the private health insurance sector. The results of the research conducted in collaboration with the International Federation of Health Plans are then presented. A discussion on key aspects of this research is then examined before we lastly, consider a way forward and the development of fraud resilience in the private insurance healthcare market
Does corruption follow opportunity? A study of the U.S. Congress
Ninety three of the 1,818 people who served in the U.S. House of Representatives between 1972 and 2012 were investigated for corruption by the Ethics Committee. Eighteen were acquitted and 75 suffered consequences (reprimand/payback/resignation/conviction). Detailed analysis of the data shows that the longer one is in Congress, the more likely is the chance of corruption. In addition, the more powerful one is in Congress, the more likely is the chance of corruption. This article concludes that corruption follows opportunity. In general, the more opportunity members of Congress have to engage in corruption, the more they will ultimately succumb to corruption.Rodrigo Praino and Adam Grayca
Dimensions of authority in oversight agencies: American and Australian comparisons
Fraud, waste, and abuse damage public administration. Responding involves law enforcement and best practice administration. Many jurisdictions create watchdog agencies to perform this role. A model, which includes seven dimensions of jurisdiction and authority that policymakers should consider when creating an oversight entity, is presented. The model goes beyond the simple functional jurisdiction, i.e., who is overseen and how oversight occurs. Four subnational watchdog agencies in two countries are examined to demonstrate the trade-offs that occur in each dimension when the agencies are designed. This analysis demonstrates there are significant balancing issues at stake, which impact watchdog effectiveness.Robin J. Kempf and Adam Grayca
Law reform: What's in it for women?
C1 - Journal Articles Referee
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