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I mean, if you want to get into it, you're both right and wrong. The second largest cases are typically against hospital chains that encourage (read: basically
by dangerlibrary 9y ago
I mean, if you want to get into it, you're both right and wrong.
The second largest cases are typically against hospital chains that encourage (read: basically force) their coding teams to use particular billing codes. It's easy enough to model this from claims data (and we did). When a chain buys a new hospital, suddenly patients that present with the same diagnosis codes are all getting extensive exams that ostensibly require 45+ minutes of a physician's time and cost 4-10x more.
Again - the large operators (hospital chains) absolutely dwarf individuals (doctors). DOJ barely has the resources to prosecute the largest offenders, and have faced repeated budget cuts. Wasting time on individual doctors or private practices (beyond maybe making examples of a few egregious actors) would be an inefficient allocation of their resources.
- ng12 9y agoDo you know the details of Palantir's investigation? How do you know they're not doing exactly what you just described? Palantir is just a data analysis company, they're not the NSA.