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Essay / Research Paper Abstract
A 4 page opinion on the legal interpretation and penalties for health care fraud. Reviewing the specifics of United States v. Sidhu, the author examines the concept of conspiracy and compares this type of crime to organized crime. Bibliography lists 3 sources.
Page Count:
4 pages (~225 words per page)
File: AM2_PPhltFrd.rtf
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Unformatted sample text from the term paper:
When an individual or an organization modifies medical records for the purpose of obtaining money they are committing fraud. Although some in our
society tend to regard it as a standard operating procedure for working within the regimentation of our nations health care system, health care fraud is just as much a crime
as any other type of crime. While there is typically no violence associated with health care fraud, it comes at a tremendous societal price and significant criminal penalties.
Unfortunately, health care fraud is not an uncommon occurrence in our society. Consequently, so too are cases of fraud that come to trial.
In United States v. Sidhu, for example, the Supreme Court heard a case involving a physician and an office assistant (Sidhu). Medical records and billings from that physicians
office were customarily modification so that insurance payments could be optimized. The office assistant perpetuated this modification both in the presence of the physician and in his absence.
In United States v. Sidhu The Court found that a conspiracy existed and charged not just the physician but also the office
assistant. The lesson that this case provides is that agreements regarding fraudulent activity can be relatively informal and still be classified as a conspiracy. Although this is a
just finding it is a terribly concerning one. As is the case in most organizations, the chain of accountability in this case runs upwards (through the institutional hierarchy), downwards
(to the patient) and even sideways (to colleagues and other professionals) dependent on the organizational structure. It might be assumed that the further away from the top of that
...