Understanding how health care markets function is important not only because competition has a direct influence on the price and utilization of health care services, but also because the proper functioning, or lack thereof, of health care markets has a very real impact on patients who depend on health care markets and providers for their personal well-being. In this dissertation, I examine the role of government policies and regulation in health care markets, with a focus on the response of health care providers. In Chapter 1, I analyze the impact of Medicare payment rules on hospital ownership of physician practices. Since the mid-2000’s, there has been a rapid increase in hospital ownership of physician practices, however, there is little empirical research which addresses the causes of this recent wave of integration. Medicare’s “provider-based” billing policy allows hospital-owned physician practices to charge higher reimbursement rates for services provided compared to a freestanding, independent physician practice, without altering how or where services are provided. This “site-based” differential creates a premium for physicians to integrate with hospitals, and the size of this differential varies with the types of health care services provided. I find that Medicare payment rules have contributed to hospital ownership of physician practices and that the response varies across physician specialties. A 10 percent increase in the relative reimbursement rate paid to integrated physicians leads to a 1.9 percentage point increase in the probability of hospital ownership for Medical Care specialties, including cardiology, neurology, and dermatology, which explains about one-third of observed integration of these specialties from 2005 through 2015. Magnitudes for Surgical Care specialties are similar, but more sensitive across specifications. There is no significant response for Primary Care physicians. In combination with other empirical literature which finds that integration between physicians and hospitals typically results in higher prices with no impact on costs or quality of care, I cautiously interpret this responsiveness as evidence that Medicare’s provider-based billing policy overcompensates integrated physician practices and leads to an inefficiently high level of vertical integration between physician and hospitals. In Chapter 2, I analyze the effect of anti-fraud enforcement activity on Medicaid spending, with a particular focus on the False Claims Act. The False Claims Act (FCA) is a federal statute which protects the government from making undeserved payments to contractors and suppliers. Individual states have chosen to enact their own versions of the federal FCA, and these statutes have increasingly been used to target health care fraud. FCA statutes commonly include substantial monetary penalties such as “per-violation” monetary fines and tripled damages, as well as a “whistleblower” provision which allows private plaintiffs to initiate a lawsuit and collect a portion of recoveries as a reward. Using variation in statelevel FCA legislation, I find state FCAs reduce Medicaid prescription drug spending by 21 percent, while other spending categories - which are less lucrative for FCA lawsuits - are unresponsive. Within the prescription drug category, drugs prone to off-label use show larger declines in response to the whistleblower laws, consistent with FCA lawsuits being used to prosecute pharmaceutical manufacturers for off-label marketing and promotion. Spending and prescription volume for drugs prone to off-label use fall by up to 14 percent. This effect could be driven by pharmaceutical manufacturers’ changes in physician detailing for drugs prone to off-label use and/or physicians’ changes in prescribing behavior.

在近幾年的台灣社會中，民眾對詐騙已經不再陌生了，政府除了成立165反詐騙專線之外，還砸下許多經費對民眾進行反詐騙的宣傳，但卻仍有上百億元的金錢被騙走，被害人除了有知識水準不高的民眾之外更不乏有高社經地位的科技新貴或是退休公務員等，可見詐騙案件與受害者的背景與教育程度無關。難道詐騙集團真的具有某種特殊能力，能讓受害者毫無警覺的付出大筆金錢?他們是如何突破受害者的心防，能夠不著痕跡的讓受害者越陷越深? 綜觀所有的詐騙案件，其實詐騙集團都有一本"教戰手冊"來做為詐騙成員和受害者聯繫的劇本，當我們將這本手冊視為一份故事腳本，透過敘事理論來分析這本"教戰手冊"，我們可以發現最後讓故事產生說服效果的其實是受害者本身的經驗投射，以及當下被詐騙集團所阻絕的情境所衍生出的結果，在這樣的狀況下，即便是政府在反詐騙文宣中極力宣導"檢察官不會監管帳戶或存款"或是"警察不會派人保管民眾的金錢"，由於受害者已經深深的陷入了詐騙情境，很難清楚的思考事件的真假...，在這樣的狀態下，反詐騙的宣傳之所以沒有對受害者產生效應就不難理解了。 政府要讓反詐騙宣傳有效果應改變方式，除了讓民眾能夠辨識事件真假之外，也應讓民眾知道當民眾捲入不法事件時可有哪些措施，同時再透過宣導短片將檢察官或是警察的辦案方式與正式流程讓民眾了解，不會因無知而繼續受騙，這樣才能真正的落實對民眾反詐騙的宣導 / People in Taiwan no longer a stranger on the scam in recent years, the government not only set the 165 anti-fraud hotline, but spent a lot of money for anti-fraud publicity, there are still hundreds of billions of dollars to be cheated. Victims include people who have different degrees of the knowledge and socioeconomic status, e.g. labor, retired civil servants…etc. It seems the occurrences of scam case have nothing to do with the background or education level of victims according to above facts. We may doubt does the fraud gang have the special ability to make people pay large sums of money without alert? How do they bewitch victims and go deeper for more money from victims? Looking at all of the scam cases, we’ve found that there is a “Scam Guideline“ to be the script for communicating between impostor and victim. We finally find the cause to affect the script is actually by the reflection of personal experience from victim as well as the isolated scenario created by fraud gang when we take the script as an appealing story and analyze it with narrative theory. In such circumstances, even though people receive the anti-fraud propaganda from government by strongly deliver "the prosecutors will not manage people’s account" or “the police will not guarantee people’s money” has not so workable; it still hard to distinguish the true or false events for victims due to they have already involved into the storyline. Government should adjust its strategy to implement the anti-fraud propaganda, besides to help people know how to tell the genuineness of the event, government also need to educate people to understand the correct methods they could take when they are related in criminal incidents, meanwhile, try to reveal the standard procedure of investigation by prosecutor or police to people via video clips, thus, people won’t be cheated with their naïve sense and the anti-fraud propaganda could be effective on the public advocacy.

Made available in DSpace on 2016-03-15T19:32:37Z (GMT). No. of bitstreams: 1 Eduardo Costa de Freitas.pdf: 3139313 bytes, checksum: f6336b321c27f3022808590cac100e63 (MD5) Previous issue date: 2013-01-24 / Fundo Mackenzie de Pesquisa / The present study had as objective to evaluate the efficiency of the monitoring activities of the internal controls system in combating corporate fraud, as the perception of professionals working in the areas of monitoring. The sample was selected based on the population of professionals accessed through the professional social network Linkedin (specific groups of audit) and relationship network, then the sample was of convenience. The instrument used to gather the answers was the Survey Monkey through which 156 replies were obtained. The analysis methodology was qualitative and based on observations defined from the theoretical that backed up the fundamentals of the job. Among the main considerations can be highlighted that the activities of internal audit, external audit, whistle blowing, Compliance and internal control Area have ability to perform their duties with efficiency in combating corporate fraud in the three branches of the tree of the fraud (Corruption, asset Misappropriation and Fraudulent financial statements) in turn, the Audit Committee has been evaluated as being efficient only to the monitoring of financial statements, evidencing the perception that the activity is more focused on the monitoring of the work performed by the external audit. It should be noted that the essence of the Committee is to monitor all activities performed for the areas responsible for monitoring internal controls system. / O presente estudo teve como objetivo avaliar a eficiência das atividades de monitoramento do sistema de controles internos no combate a fraudes corporativas, conforme a percepção dos profissionais que atuam nas áreas de monitoramento. A amostra foi selecionada tendo como base à população dos profissionais da área acessados através da rede social profissional Linkedin (grupos específicos de auditoria) e rede de relacionamento, logo a amostra foi de conveniência. O instrumento usado para coletar as respostas foi o SurveyMonkey através do qual foram obtidas 156 respostas. A metodologia de análise foi qualitativa e quantitativa, baseada em observações definidas a partir do arcabouço teórico que respaldou os fundamentos do trabalho. Entre as principais considerações pode-se destacar que as atividades de Auditoria Interna, Auditoria Externa, Canal de Denúncias, Compliance e Área de Controles Internos possuem capacidade para executar suas funções com eficiência no combate às fraudes corporativas nas três ramificações da Árvore da Fraude (Corrupção, Apropriação Indébita de Ativos e Demonstrações Financeiras Fraudulentas) Por sua vez, o Comitê de Auditoria foi avaliado como sendo eficiente apenas para o acompanhamento das demonstrações financeiras, evidenciando a percepção de que a atividade está mais voltada para o acompanhamento dos trabalhos executados pela auditoria externa. Ressalta-se que a essência do comitê é acompanhar todas as atividades executadas pelas áreas responsáveis pelo monitoramento do sistema de controles internos.

Made available in DSpace on 2016-03-15T19:32:52Z (GMT). No. of bitstreams: 1 Ms Caio Marcelo Suplicy Mazzola.pdf: 112263 bytes, checksum: eab1723b5da7b146bf211151ae5fa66e (MD5) Previous issue date: 2015-02-04 / Fundo Mackenzie de Pesquisa / The present study aimed to evaluate the applicability of internal controls and compliance activities in combating corporate fraud, as the perception of professionals working in the areas of monitoring. The research sample was selected based on the population of professionals in the areas of internal control, auditing and controllership, accessed through the professional social network Linkedin (specific groups of professionals in the field) and relationship network, then the sample was convenience. The instrument used to collect the 102 responses answers was the SurveyMonkey. The methodology was qualitative and quantitative analysis, based on observations defined from the theoretical to the foundations of the program work. Among the main considerations you can emphasize that the activities resulting from the implementation of a code of ethical conduct and the channel of complaints through internal controls and tools subsequently monitored through the areas of compliance and internal audit have conditions to minimize corporate fraud in the three main strands of the tree of the fraud (Corruption, misappropriation of assets and fraudulent financial statements). Highlighting the perception of respondents, despite the growing trend of incidents, is irrefutable the knowledge about the subject, communication, monitoring, being compliance, as well as periodic review of internal controls and regulatory are tools fully viable as to the applicability to combat corporate fraud in Brazil. / O presente estudo tem como objetivo avaliar a aplicabilidade das atividades de controles internos e compliance no combate a fraudes corporativas, conforme a percepção dos profissionais que atuam nas áreas de monitoramento. A amostra pesquisada foi selecionada tendo como base a população de profissionais das áreas de controle interno, auditoria e controladoria, acessados através da rede social profissional Linkedin (grupos específicos de profissionais da área) e redes de relacionamentos; logo a amostra foi de conveniência. O instrumento usado para coletar as 102 respostas foi o SurveyMonkey. A metodologia de análise foi qualitativa e quantitativa, baseada em observações definidas a partir da estrutura teórica que respaldou os fundamentos do trabalho. Entre as principais considerações pode-se destacar que as atividades resultantes da implantação de um código de conduta ética e do canal de denúncias, por meio das ferramentas de controles internos e posteriormente monitorados pelas áreas de compliance e de auditoria interna, possuem condições para minimizar as ocorrências de fraudes corporativas. Evidenciando a percepção dos pesquisados, apesar da tendência crescente dessas ocorrências, é irrefragável que o conhecimento, a comunicação, o monitoramento continuo, o estar em compliance, bem como a revisão perene dos normativos e controles internos são alicerces funcionais no combate às fraudes corporativas no Brasil.

The aim of the research was to look at the motivations behind white-collar crime and, by means of the insights gained, allow businesses to achieve a better understanding of these motivations and the possible loopholes that exist with respect to white-collar crime. Empowered which such knowledge, businesses fraud mitigation polices and approaches are enhanced; which contribute towards sustained operations and increased shareholder value by reduce losses. Face-to-face interviews were held with 29 white-collar offenders imprisoned at the Johannesburg Medium Correctional Centre in Gauteng, South African. Data was collected from these interviews and grouped into themes that related to the research questions. An action plan was formulated to assist business in their fight to eliminate and reduce the impact of commercial crime. / Dissertation (MBA)--University of Pretoria, 2012. / Gordon Institute of Business Science (GIBS) / unrestricted

Zugl.: Augsburg, Universiẗat, Diss., 2005.

This work deals with the protection of European Union economic market from the view of the collaboration of individual customs boards of the union. The protection of the market is presented as the basic mission in conjunction with the methods and the processes of uncovering of serious criminal activities. It is introduced as a legal framework for activities and collaboration and also some examples of practical use are also given. The work also defines the role of the customs organs in the field of international collaboration related to enforcing the law and uncovering of attempts of illegal trade of goods within the lands of EU.