Legal Case Medical Fraud

It is the dream of every person to never visit the hospital. However it becomes very difficult for this to happen as from time to time, people will get sick and therefore will have to go to hospital. However, every time that one visits the hospital, he hopes that he will be in the hospital for the shortest time possible and therefore he will have to pay the least amount of money possible. However, in the recent past, this has not been the case.

Hospitals which are supposed to exercise ethical conducts in medical professionalism are no longer ethical. They are involved in cases of fraud where they will intentionally delay patients so that they can have escalating bills. This has been evident in some nine hospitals in seven states in the United States. This is against the professional code of ethics of medical professionals and it can be described as a form of a white collar crime. It should therefore be discouraged. (Kennedy, 2009)

Other than this, there have been a lot of cases where medical bills have been presented to the patients with errors, poor presentation of diagnoses information and prescription of additional treatment which is unnecessary all with the aim of making more money. Other bills have been presented to the patients written in medical terms. This makes it difficult for the patient to analyze the bill and therefore have a clear understanding of what is happening and what he is paying for.

It is due to this reason that the government of the United States came up with an act of parliament which was referred to as “Prevent Health Care Fraud Act of 2009”. (Medical. Net, 2009) This act was endorsed by the American Homecare Association and it has the main aim of improving available resources and tools used to reduce or even prevent cases of medical fraud. It is the requirement of this bill that there should be real time screening and auditing done in healthcare institution. This is usually done so as to catch any case of fraudulent activity that may be taking place within the healthcare facility.

In addition, the act recommends that there should be frequent and irregular onsite inspection which is aimed at noting any unnecessary activity that may be taking place within the healthcare institution. (law. cornell. edu, 2010) Medical fraud has very serious implication on the life of innocent citizens. There have been a lot of cases of medical fraud despite the existence of programs and Acts of Parliament that are supposed to help curb this unethical conduct. It is due to this reason that the court has also taken some measures which are aimed at reducing cases of medical fraud.

In case a healthcare institution is found to intentionally delay the patient so that they can pay more money, the institution is charged with a number of offences. First, the court charges such institution with the offence at hand which is medical fraud through delayed practices. In addition, the institution is charge with all the other related conduct and all the persons involved. This means that the overall sentence of such a suspect will be about fifty percent more than it would have been in the normal medical fraud case.

The main aim of this is to discourage people or healthcare institutions from intentionally delaying patients. There are some patients that succumb to their illness due to this delay and this should be prevented. (cynics4bettertomorrow. org, 2010) In conclusion, it is clear that despite the efforts that the government is making to ensure that medical fraud is eliminated, hospitals or healthcare institution are still involved in these unethical and unprofessional practices.

The government in collaboration with the Criminal Justice System is therefore taking extreme measures to ensure that this form of white collar crime is eliminated. It is clear that some healthcare institutions in different states have paid a fortune for this. All this is aimed at discouraging all the other hospitals from participating. ? References cynics4bettertomorrow. org. (2010, May 9). Medical Billing Fraud’s Ripe Environment. Retrieved June 5, 2010, from http://cynics4bettertomorrow. org/wordpress/? p=44 Kennedy, K. (2009, July 29).

Dozens Arrested In Medicare Fraud Busts Across US . Retrieved June 5, 2010, from http://www. huffingtonpost. com/2009/07/29/federal-agents-raid-houst_n_246883. html law. cornell. edu. (2010, May 28). Health Care Fraud. Retrieved June 5, 2010, from http://topics. law. cornell. edu/wex/healthcare_fraud Medical. Net. (2009, November 26). Prevent Health Care Fraud Act of 2009. Retrieved June 5, 2010, from http://www. news-medical. net/news/20091126/Prevent-Health-Care-Fraud-Act-of-2009-American-Association-for-Homecare-endorses-bill. aspx