Most of the meters are read wirelessly now.
A utility car/truck drives slowly around a neighborhood and picks up the periodic blind broadcast from meters in the area, typically on the ISM (Industrial, Scientific, Medical) radio band.
I put together a quick Raspberry Pi solution with a software defined radio receiver and I could pick up about 20 meters from inside my house (4 were my own, 16 were other people's).
As far as tampering, the primary control against tampering is that the penalties are fairly severe. There's nothing in particular that would stop you physically from removing your meter and jumpering across the lugs, or wiring a relay that would intermittently jumper across them. There are "tamper" flags that are broadcast in the ISM stream; I didn't look into what causes them to be set, but I did note that my electric meter tamper flag was set, despite my not having tampered with anything, so I doubt that the utility makes great use of that data. If your electric bill suddenly drops to 20% of its previous value, I imagine the utility might look into without a tamper flag in the stream. (Note also that they can monitor your power usage without ever setting foot on your property. This also means that the usage information is available to others, some of whom might be trying to profile whether your property is occupied or not.)