MEDICAL CRIME
Introduction
Medical crime is defined as any illegal act, which is committed within the area of medical practice (Dooley, 2016). There are different types of medical crimes that can be committed by a medical physician. This include things such as Medicare Fraud, Phantom Billing, Conflicts of interest, kickbacks, double billing, billing for unnecessary services, medical mal-practice and bribery. In order for a medical professional to be convicted of a white-collar crime, the prosecution has to be able to prove the following key-points. It has to show that the accused physician acted with the intent of engaging in the fraudulent activity toward the patient or and the applicable health plan (Dooley, 2016). In case it is a medical fraud case, the prosecution has to show that the physician made a conscientious decision to provide false information. The sole purpose of this was to request monetary payment from the health plan.
It is also important to provide evidence that the physician benefitted from the crime that is he, she committed i.e. he, or she received an unjustified or excessive payment from the criminal activity. Crime IncidentIn an article that was printed in the L.A. Times on April 26, 2013 by Chad Terhune showed that an L.A. Jury found three people guilty for a Medicare fraud scheme. The federal jury found Godwin Onyeabor, 49 an officer at Fendih Medical Supply Inc. in San Bernardino had paid kickbacks to physician Sri J. Wijegunaratne, and Heidi Morishita. The purpose of the kickbacks was for fraudulent prescriptions for durable medical equipment (Terhune, 2015). The Medicare officials stated that the scheme ran for about six years i.e. from 2007 to 2012, and the prescriptions resulted to Medicare being billed $1.5 million for false and fraudulent claims. Medicare had already paid about $1 million on the claims. Several Medicare patients testified at the trial saying that they had been promised with items such as vitamins and juice. However, they were provided with wheelchairs that they did not need. If prosecuted, the three will face up to ten years in prison and a $250,000 fine for each count that they are found guilty.
Reaction and Analysis
When one looks at the case above, one realizes that medical fraud can easily be committed and the perpetrators can benefit for a long period from their criminal activities. The parties involved knew how the Medicare worked, and they were in a position, given their connections to run their scheme successfully for about six years (Terhune, 2015). It shows that people can manipulate the Medicare system, and personally benefit for what is meant for the patients. Although this is a federal run program, it is estimated that about $60 billion is lost annually through fraudulent schemes.This is a serious crime. Medicare is a federal health insurance program for people who are 65 years and older, people with disabilities, and people who have End-Stage Renal Disease (Altman & Frist, 2015). Therefore, the perpetrators of the crime were stealing money that is meant for sick people, …
