Reducing Waste through Anti-Fraud Enforcement: Evidence from Hospital Admission Cases

David H. Howard and Jetson Leder-Luis

No 34938, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: The use of federal anti-fraud laws to address unnecessary medical care is controversial. Targeted providers frequently argue that, in their judgment, the treatment in question was appropriate. We examine the effects of anti-fraud litigation against hospitals for over-admitting patients from the emergency department, using 100% Medicare claims for 2005-2019 and a design based on the staggered rollout of these lawsuits. We find that anti-fraud lawsuits reduced admission rates by 3.6 percentage points without increasing mortality rates. We estimate five-year savings to Medicare of $1.3 billion. Our results suggest that anti-fraud enforcement can be successful in reducing costly, unnecessary care.

JEL-codes: D73 I18 K42 (search for similar items in EconPapers)
Date: 2026-03
New Economics Papers: this item is included in nep-hea and nep-law
Note: AG EH LE
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