The Forgiveness of Coinsurance: Charity or Cheating?
Lachs, Mark S.
Sindelar, Jody L.
Horwitz, Ralph I.
New England Journal of Medicine. 1990 May 31; 322(22): 1599-1602.
Forgiving coinsurance is the practice of accepting a third party payer's reimbursement as total compensation for services rendered to a patient while waiving the patient's share of the bill. The authors' study of the issue revealed that forgiveness of coinsurance encompasses a range of activities from altruism to fraud. They offer four vignettes to illustrate the ways in which forgiveness of coinsurance is used and consider its effect on patients, providers, and society. Lachs, et al. conclude that their preliminary data on the forgiveness of coinsurance suggest that the practice needs further study because it frequently accompanies other forms of fraud. They recommend that the medical profession take the lead in developing guidelines to govern the forgiveness of coinsurance before legislative initiatives limit even altruistic uses of the practice. (KIE abstract)
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