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  1. Detecting Fraud in Development Aid
    Autor*in: Ensminger, Jean Evelyn; Leder-Luis, Jetson
    Erschienen: December 2022
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    When organizations have limited accountability, antifraud measures, including auditing, often face barriers due to institutional resistance and practical difficulties on the ground. This is especially true in development aid, where aid organizations... mehr

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    Verlag (lizenzpflichtig)
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    Standort:
    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
    Fernleihe:
    keine Fernleihe

    Standort:
    Universitätsbibliothek Freiburg
    Fernleihe:
    keine Fernleihe

    Standort:
    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
    Fernleihe:
    keine Fernleihe

    Standort:
    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
    Fernleihe:
    keine Fernleihe

     

    When organizations have limited accountability, antifraud measures, including auditing, often face barriers due to institutional resistance and practical difficulties on the ground. This is especially true in development aid, where aid organizations face incentives to suppress information about misappropriated funds and may operate with limited transparency. We develop new statistical tests to uncover strategic data manipulation consistent with fraud. These tests help identify falsified expense reports and facilitate monitoring in difficult-to-audit circumstances, relying only on mandated reporting of data. While the digits of naturally occurring data follow the Benford's Law distribution, humanly-produced data instead reflect behavioral biases and incentives to misreport. Our new tests improve upon existing Benford's Law tests by being sensitive to the value of digits reported, which distinguishes between intent to defraud and error, and by improving statistical power to allow for finer partitioning of the data We apply this method to a World Bank development project in Kenya. Our evidence is consistent with higher levels of fraud in harder to monitor sectors and in a Kenyan election year when graft also had political value. The results are validated by qualitative data and a forensic audit conducted by the World Bank. We produce simulations that demonstrate the superiority of our new tests to the standards in the field. Our tests are useful beyond development aid, including for monitoring corporate accounting and government expenditures

     
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    Quelle: Verbundkataloge
    Sprache: Englisch
    Medientyp: Buch (Monographie)
    Format: Online
    Schriftenreihe: NBER working paper series ; no. w30768
    Schlagworte: Entwicklungsprojekt; Entwicklungshilfe; Projektbewertung; Betrug; Internes Kontrollsystem; Statistischer Test; Kenia; Other; Bureaucracy; Administrative Processes in Public Organizations; Corruption; Public Administration; Public Sector Accounting and Audits; Auditing; Project Analysis
    Umfang: 1 Online-Ressource, illustrations (black and white)
    Bemerkung(en):

    Hardcopy version available to institutional subscribers
  2. Dying or Lying?
    For-Profit Hospices and End of Life Care
    Autor*in: Gruber, Jonathan; Howard, David H.; Leder-Luis, Jetson; Caputi, Theodore L.
    Erschienen: March 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    The Medicare hospice program is intended to provide palliative care to terminal patients, but patients with long stays in hospice are highly profitable, motivating concerns about overuse among the Alzheimer's and Dementia (ADRD) population in the... mehr

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    Standort:
    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
    Fernleihe:
    keine Fernleihe

    Standort:
    Universitätsbibliothek Freiburg
    Fernleihe:
    keine Fernleihe

    Standort:
    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
    Fernleihe:
    keine Fernleihe

    Standort:
    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
    Fernleihe:
    keine Fernleihe

     

    The Medicare hospice program is intended to provide palliative care to terminal patients, but patients with long stays in hospice are highly profitable, motivating concerns about overuse among the Alzheimer's and Dementia (ADRD) population in the rapidly growing for-profit sector. We provide the first causal estimates of the effect of for-profit hospice on patient spending using the entry of for-profit hospices over twenty years. We find hospice has saved money for Medicare by offsetting other expensive care among ADRD patients. As a result, policies limiting hospice use including revenue caps and anti-fraud lawsuits are distortionary and deter cost-saving admissions

     
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    Quelle: Verbundkataloge
    Sprache: Englisch
    Medientyp: Buch (Monographie)
    Format: Online
    Schriftenreihe: NBER working paper series ; no. w31035
    Schlagworte: Pflegeheim; Privatwirtschaft; Alterskrankheit; Pflegefinanzierung; Gesetzliche Krankenversicherung; USA; Government Expenditures and Health; Health Insurance, Public and Private; Legal Procedure, the Legal System, and Illegal Behavior
    Umfang: 1 Online-Ressource, illustrations (black and white)
    Bemerkung(en):

    Hardcopy version available to institutional subscribers
  3. Unsupervised Machine Learning for Explainable Health Care Fraud Detection
    Autor*in: Shekhar, Shubhranshu; Leder-Luis, Jetson; Akoglu, Leman
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    The US spends more than 4 trillion dollars per year on health care, largely conducted by private providers and reimbursed by insurers. A major concern in this system is overbilling, waste and fraud by providers, who face incentives to misreport on... mehr

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    Standort:
    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
    Fernleihe:
    keine Fernleihe

    Standort:
    Universitätsbibliothek Freiburg
    Fernleihe:
    keine Fernleihe

    Standort:
    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
    Fernleihe:
    keine Fernleihe

    Standort:
    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
    Fernleihe:
    keine Fernleihe

     

    The US spends more than 4 trillion dollars per year on health care, largely conducted by private providers and reimbursed by insurers. A major concern in this system is overbilling, waste and fraud by providers, who face incentives to misreport on their claims in order to receive higher payments. In this work, we develop novel machine learning tools to identify providers that overbill insurers. Using large-scale claims data from Medicare, the US federal health insurance program for elderly adults and the disabled, we identify patterns consistent with fraud or overbilling among inpatient hospitalizations. Our proposed approach for fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing reasoning and interpretable insights into the potentially suspicious behavior of the flagged providers. Data from the Department of Justice on providers facing anti-fraud lawsuits and case studies of suspicious providers validate our approach and findings. We also perform a post-analysis to understand hospital characteristics, those not used for detection but associate with a high suspiciousness score. Our method provides an 8-fold lift over random targeting, and can be used to guide investigations and auditing of suspicious providers for both public and private health insurance systems

     
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    Quelle: Verbundkataloge
    Sprache: Englisch
    Medientyp: Buch (Monographie)
    Format: Online
    Schriftenreihe: NBER working paper series ; no. w30946
    Schlagworte: Gesundheitsversorgung; Versicherungsbetrug; Künstliche Intelligenz; USA; Other; Bureaucracy; Administrative Processes in Public Organizations; Corruption; Health Insurance, Public and Private; Illegal Behavior and the Enforcement of Law; Auditing
    Umfang: 1 Online-Ressource, illustrations (black and white)
    Bemerkung(en):

    Hardcopy version available to institutional subscribers
  4. Maimonides rule redux
    Autor*in: Angrist, Joshua D.; Lavy, Victor; Leder-Luis, Jetson; Shany, Adi
    Erschienen: June 2017
    Verlag:  National Bureau of Economic Research, Cambridge, MA

    Standort:
    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
    Signatur:
    W 1 (23486)
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    uneingeschränkte Fernleihe, Kopie und Ausleihe
    Export in Literaturverwaltung   RIS-Format
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    Quelle: Verbundkataloge
    Sprache: Englisch
    Medientyp: Buch (Monographie)
    Format: Druck
    Schriftenreihe: Working paper series / National Bureau of Economic Research ; 23486
    Schlagworte: Allgemeinbildende Schule; Schüler; Bildungsniveau; Schätzung; Israel; Klassengröße; class size
    Umfang: 40 Seiten, Illustrationen
    Bemerkung(en):

    Erscheint auch als Online-Ausgabe
  5. Government Audits
    Autor*in: Cuneo, Martina; Leder-Luis, Jetson; Vannutelli, Silvia
    Erschienen: February 2023
    Verlag:  National Bureau of Economic Research, Cambridge, Mass

    Audits are a common mechanism used by governments to monitor public spending. In this paper, we discuss the effectiveness of auditing with theory and empirics. In our model, the value of audits depends on both the underlying presence of abuse and the... mehr

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    Verlag (lizenzpflichtig)
    Resolving-System (lizenzpflichtig)

    Standort:
    Sächsische Landesbibliothek - Staats- und Universitätsbibliothek Dresden
    Fernleihe:
    keine Fernleihe

    Standort:
    Universitätsbibliothek Freiburg
    Fernleihe:
    keine Fernleihe

    Standort:
    Helmut-Schmidt-Universität, Universität der Bundeswehr Hamburg, Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky
    Fernleihe:
    keine Fernleihe

    Standort:
    Technische Informationsbibliothek (TIB) / Leibniz-Informationszentrum Technik und Naturwissenschaften und Universitätsbibliothek
    Fernleihe:
    keine Fernleihe

    Standort:
    ZBW - Leibniz-Informationszentrum Wirtschaft, Standort Kiel
    Fernleihe:
    keine Fernleihe

     

    Audits are a common mechanism used by governments to monitor public spending. In this paper, we discuss the effectiveness of auditing with theory and empirics. In our model, the value of audits depends on both the underlying presence of abuse and the government's ability to observe it and enforce punishments, making auditing most effective in middling state-capacity environments. Consistent with this theory, we survey all the existing credibly causal studies and show that government audits seem to have positive effects mostly in middle-state-capacity environments like Brazil. We present new empirical evidence from American city governments, a high-capacity and low-impropriety environment. Using a previously unexplored threshold in federal audit rules and a dynamic regression discontinuity framework, we estimate the effects of these audits on American city finance and find no marginal effect of audits

     
    Export in Literaturverwaltung   RIS-Format
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    Quelle: Verbundkataloge
    Sprache: Englisch
    Medientyp: Buch (Monographie)
    Format: Online
    Schriftenreihe: NBER working paper series ; no. w30975
    Schlagworte: Interne Revision; Finanzkontrolle; Kommunalverwaltung; Kommunale Ausgaben; USA; Bureaucracy; Administrative Processes in Public Organizations; Corruption; Public Administration; Public Sector Accounting and Audits; Auditing
    Umfang: 1 Online-Ressource, illustrations (black and white)
    Bemerkung(en):

    Hardcopy version available to institutional subscribers