пятница, 2 сентября 2016 г.

Medicare providers

This study adopts the conceptual framework proposed by Richard Lawlor for applying agency
theory to the Medicare program. Lawlor’s framework will be described in detail in subsequent
sections of this chapter. As applied to this study, Lawlor’s agency framework will demonstrate
the imperfect aspects of the contract-like arrangements that exist between: 1) CMS and Medicare
providers, 2) CMS and Medicare contractors, 3) Congress, the Executive Branch, and
whistleblowers, 4) Congress and the Judicial Branch (Federal courts). These imperfect contractlike
arrangements allow for miscommunication between the principals and their agents, and in
many instances require the principals to monitor their agents as a means of combating any
potential shirking.

It must be noted again that this research relies on the understanding of agency theory that is used
in the social sciences. This must not be confused with the legal concept of agency, which differs
profoundly from the social sciences’ concept. Within the legal realm, the concept of agency is
oriented toward corporations and contracts, and turns on control, authority, and accountability
(Gregory & Reuschlein, 2001, pp. 4-5). The notion of the principal’s liability for the agent’s
actions is key to the legal understanding of the concept. In contrast, the notion of incentives—
how to encourage an agent to act the most efficiently on the principal’s behalf—is the driving
concern behind agency theory in the social sciences (Rasmusen, 2004, p. 370).

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