Although the definition of "health care fraud" is only one of the numerous issues of concern to health law practitioners and health care providers, the language that defines the conduct in question is the foundation of all other concerns related to "health care fraud." This Article will demonstrate the need for a narrowly construed definition of "health care fraud." The Article begins by providing a scenario to explain how a situation involving potential "health care fraud" can arise in the delivery of health care services. The Article then addresses how "health care fraud" is defined through a discussion of the process of the applicable proceedings and the penalties that may result. The Article concludes by proposing a way to define "health care fraud" that will result in a system of sanctions that is equitable and proportional to the conduct committed by the health care provider.
Yvette M. Mastin, The Punishment of Health Care Fraud, 15 J.L. & Health 53 (2000-2001)