Do you need this or any other assignment done for you from scratch?
We have qualified writers to help you.
We assure you a quality paper that is 100% free from plagiarism and AI.
You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)
NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.
NB: All your data is kept safe from the public.
Corruption, misuse, and wastage afflict the healthcare sector in the United States. Individuals commonly associate fraud with identity theft or deceptive invoicing methods, and although these issues are undoubtedly prevalent in today’s system, fraud also takes the aspect of kickbacks. Kickbacks are agreements between caregivers whereby an entity sends patients to another agency in exchange for services, commodities, or medications. Medical practitioners are meant to recommend diagnostic tests depending on their expertise and training, never based on monetary obligations from external physicians or corporations. Practitioners make judgments that are rarely in patients’ best interests when influenced by bribes. This essay analyzes a medical care fraud and kickback scheme that saw a woman in New Orleans get fined and sentenced to prison for her involvement in the plan.
A lady from New Orleans was declared guilty of taking a role in a $3.2 million Healthcare fraud and kickback scam involving false invoicing for powered wheelchairs and various hospital devices. Sandra Parkman, who is in her 60s, was found guilty on one charge of medical fraud conspiracy, one count of conspiracy to offer and accept kickbacks, two charges of Medicare fraud, and five offenses of taking kickbacks by a federal grand jury (“New Orleans woman sentenced,” 2018). The verdicts came after a trial that lasted three days in New Orleans under U.S. District Judge Engelhardt. Parkman was sentenced to spend $277,197 in reparation by Judge Engelhardt. According to witness statements given at trial, Parkman and associates participated in a plan to steal Medicare for five years, from 2004 to 2009. They accomplished this by providing Medicare recipients across New Orleans with medically unneeded durable healthcare devices.
Parkman got kickback payouts from co-defendant Tracy Richardson Brown, the proprietor of an appliance supplying firm. Further evidence showed that Parkman collected doctor confirmations on purchase orders for medically inappropriate devices and gave specific identifiable details of qualified Medicare enrollees. Parkman earned well over $45,000 in bribe money due to the conspiracy, while Brown led Medicare to spend approximately $3.2 million solely on unlawfully acquired recommendations, according to the evidence. However, during a Trial in August 2016, Brown was found guilty and sentenced to prison for eighty months (“New Orleans woman sentenced,” 2018). The Office of Inspector General for the United States Department of Health and Human Services (HHS-OIG) and the Federal Bureau of Investigation (FBI) examined Parkman’s case. Healthcare and Medicaid Facilities, in collaboration with the HHS-OIG, are trying to improve transparency and reduce the prevalence of fraudulent services.
The federal authorities have been greatly concerned about healthcare corruption and exploitation for the last three decades. Financial penalties, prison sentences, and removal from federal medical programs are the administrative and criminal punishments for breaking the anti-kickback statute (AKS). Exclusion bars an individual or company from directly invoicing Medicare for any services and goods (Sousa et al., 2019). In addition, it makes it difficult for a healthcare professional to operate in or deal with organizations that get financing from government welfare programs. Healthcare professionals who give or receive bribes incur approximately $50,000 for every kickback and three times the sum of the reward per the Civil Money Penalties Law (CMPL). Similarly, if guilty of producing fraudulent assertions as defined by the False Claims Act, a suspect might receive a maximum jail term of up to five years.
The outcome of Parkman’s penalty was appropriate since the punishment received was within the law. According to the law, when a healthcare practitioner is found guilty of fraud, they pay a fine worth $50,000 for each kickback. The evidence showed that Parkman had committed five kickbacks offenses and was fined a total of $277,197, per the law. In addition, Parkman was sentenced to thirty-two months in prison within the range of two to five years as per the punishment of breaking the anti-kickback statute. Considering the potential consequences of this conviction, health care workers being investigated for any of such charges should seek the advice of an advocate specializing in this field (Sousa et al., 2019). An attorney could be equipped to assist an individual in justifying their professional activities or identifying alternative defense options.
To identify and eliminate healthcare fraud and misconduct, practitioners should adopt complete compliance systems and enhance medical billing operations. A good program enhances cooperation across management and employees. Since workers cannot be deemed liable for laws and requirements they are unaware of, the program involves a procedure for drafting, amending, disseminating, and monitoring compliance policies (Sousa et al., 2019). On the other hand, staff can remain concentrated on the institution’s larger aims and assist activities function effectively if they grasp objectives. Personnel who have been adequately instructed on compliance rules are also highly inclined to notice and condemn unlawful or unethical behavior (Mackey et al., 2018). Workers who comply are better able to accomplish their duties, achieve their professional objectives, and keep patients pleased. As a result, a healthcare organization may meet its objectives and expand more quickly.
In conclusion, the healthcare sector in the United States is a complicated structure with many stakeholders and many resources. As a result, it is susceptible to corruption, misuse, and wastage. Preventing kickbacks is one of the larger endeavors to ensure that individuals get treatment centered on logical decision-making rather than selfish monetary gain. Medical fraud and kickback policies are anticipated to alter while the healthcare sector adopts improved service delivery and insurance compensation guidelines. To avoid possible fraud probes, medical providers must ensure that their organizations are up to speed and adhere to current requirements.
References
Mackey, T. K., Vian, T., & Kohler, J. (2018). The sustainable development goals as a framework to combat health-sector corruption. Bull World Health Organ, 96(9), 634-643. Web.
New Orleans woman sentenced to prison for role in $3.2 million health care fraud and kickback scheme. (2018). United States Department of Justice. Web.
Sousa, M. J., Pesqueira, A. M., Lemos, C., Sousa, M., & Rocha, A. (2019). Decision-making based on big data analytics for people management in healthcare organizations.Journal of Medical Systems, 43(290), 125-138. Web.
Do you need this or any other assignment done for you from scratch?
We have qualified writers to help you.
We assure you a quality paper that is 100% free from plagiarism and AI.
You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)
NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.
NB: All your data is kept safe from the public.