Publication date: Apr 11, 2019
Insurers may not be able to look across national data to find the telltale signs of this kind of fraud, but School of Public Health researchers can, with help from a top former federal healthcare regulator, a Washington, DC-based law and consulting firm, and some undercover -mystery shoppers. “
Together with support from the Laura and John Arnold Foundation, part of Arnold Ventures, four professors from the Department of Health Law, Policy & Management are working on a two-year project to identify insurance claims patterns that point to substance use disorder treatment scams; they will then build a tool for insurers and regulators to understand just how big the problem is, and how to stop it.
-This problem affects everybody,” says Melissa Garrido, research associate professor of health law, policy & management, and the lead researcher on the study.
In this phase, they are also interviewing key stakeholders-people working in regulation, law enforcement, and opioid use disorder treatment-in Florida, California, Texas, New York, and Pennsylvania; all are states with areas of high per-capita opioid use disorder rates and large numbers of opioid treatment programs.
Steven Pizer, associate professor of health law, policy & management and PEPReC’s chief economist, will then work with Garrido on the claims analysis and developing the algorithm.
Health economist Austin Frakt, associate professor of health law, policy & management, director of PEPReC, and a writer who regularly contributes to the New York Times’s Upshot column, will work with the team to disseminate the research findings to a broader audience.
|disease||MESH||substance use disorder|
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