“Seven People Charged In New Jersey Massive Health Care Fraud Scheme Involving Telemedicine and Durable Medical Equipment (DME)”

                This case has been considered as one of the biggest health care fraud schemes which  inspected by the  along with the help of the  and also put on trial by the  which led to the in charges counter to  suspects, with seven of them were accused in the  – counting as well the and also others who connected with five medicine firms, the holders of lots of  firms and three certified medical specialists, on behalf of their suspected contribution in health care fraud schemes containing above than , along with the carrying out of more than  search authorizations in . Furthermore, the  along with the   declared that it grabbed for argumentative managerial accomplishment counter to  firms that had given in to more than  in privileges and were compensated for more than .

        The case was about numbers of medical specialists who have done the criminal health care fraud schemes with the help of some medicine firms. The suspected medical specialists, in this case, get the help from certain call centers in the Philippines and also Latin America to fool the disabled patients to order  as they have prescribed them to. They convinced the patients throughout the international call centers and promoted for the Medicare receivers along with  the receivers to make them accept the various numbers of   supports without any medical requirements. These suspects — who are a variety from commercial business executives to medical specialists which all of them were apparently take part in massive and complex fraud to take the advantages from medicine technology which designed for patients or else they will not be capable to access the health care. However, the charges against the suspects are purely contentions, and the defendants are assumed to be still innocent until they will be proven guilty further than a rational suspicion in a court of law.

Resource:https://www.justice.gov/usao-nj/pr/seven-people-charged-new-jersey-massive-health-care-fraud-scheme-involving-medicine

Ethical Problem of the biggest health care fraud schemes

            The ethical problem from this case is how the medical specialists were able to work with deceitful medicine firms for twisted, sceptical and knee braces that are actually medically redundant. Also, the fact that numbers of suspects apparently took control on a global telemarketing network that attracted about thousands incapacitated patients and also patients advanced years into an illegal outline that crossed the boundaries and including call centers in the Philippines as well as call centers over Latin America. The suspects have made fool the patients with giving some money to numbers of doctors to make prescription for  without any communication with the patients or with just via a short conversation through the telephone with the patients that they actually never had seen before. This is definitely against the code of ethics where the medical specialists are supposed to help people or patients regarding their health problems (Hall, Orentlicher, Bobinski, Bagley, & Cohen, 2018). But the medical specialists in this case have made great fraud scheme by fooling the patients and convinced them to accept their offer which is actually a fraud. Plus, the suspects were also using the weakness of the patients which not capable of accessing the health care to convince them accepting the medicine prescription fraud.

Why Is This Case Morally Important of the biggest health care fraud schemes

        “The Health Care Fraud Scheme Involving Medicine and Durable Medical Equipment (DME)” case which happened in  is morally important due to this case has against the code of ethics that the entire medical specialists should able to conduct, which is giving the correct and proper prescription for the patients who really need it. The medical specialists should not make a fool or dishonest the innocent and disabled patients with using their incapability to drag them in the criminal action to get their own profits (Iltis, 2013). This is definitely not the typical moral that every medical specialists need to have in order to serve the needed patients. And for this reason, this case is definitely morally important, and the suspects should be punished as what they have done to make them, and also other people learn from this case as well. In addition, this criminal action was not performed by only one or two suspects. Instead, it mentioned for wide-ranging corruption, great amounts of greediness, as well as the general faults in the healthcare structure that were misused by the suspects.

Key Events and Evidence of the biggest health care fraud schemes

        The key events from this case are when the medical specialists made fraudulent prescriptions of  for incapacitated patients and also elderly patients without any communications with the related patients first. The pieces of evidence arrived from $1.2 billion in cost, and also counting the completing of more than 80 search licenses in 17 federal districts. Moreover, the Center for Medicare Services, Center for Program Integrity (CMS/CPI) announced that it grabbed for argumentative managerial accomplishment counter to  firms that had given in to more than  in privileges and were compensated for more than .

Resource:https://www.justice.gov/usao-nj/pr/seven-people-charged-new-jersey-massive-health-care-fraud-scheme-involving-medicine

Stakeholder Analysis of the biggest health care fraud schemes

            The stakeholders from this case are the CEOs, COOs, executives, business owners, medical specialists along with the international call centers which located in the Philippines and also Latin America that have given the support to promoted the fraudulent calls advertising to the Medicare receiver to receive their offer. All of them have been blamed for affecting for more than . These stakeholders definitely have gain benefits from this criminal conspiracy without recognizing the consequences that they would get or the effect for the innocent patients that they have fooled within their illegal activities. The stakeholders in this case seem to gain quite a big amount of revenue from made a fraud prescription for the innocent patients. And if we analyze, some of the stakeholders came from the medical field which supposed to realize about the code of ethics they should perform for the patients that really need their assistance, but they neglected those ethics to get their own profits (Darr, 2018).

Moral Urgency of the biggest health care fraud schemes

            “The Health Care Fraud Scheme Involving Medicine and Durable Medical Equipment (DME)” case which happened in  could be defined as a corruption case in the health sector which became a complicated occurrence and a problematic challenge to be solved. The moral urgency of this case is located on undermining the moral vision as well as the dignity of the real meaning of health and healing and also to develop the effective and efficient approaches to handle the risk and giving the protection for the moral vision of medical as well. Corruption in this case is definitely has damaged the moral vision of medical. Ethics lies at the heart of medicine-it is difficult to imagine a good but corrupt physician. Some people probably would not agree that medicine with short morality has turned this term into stealing, bribery and also criminality. The people who have embraced an honourable career or profession in the medical field cannot do anything when its ethical groundwork is being died out by immoral and corrupt performs from the irresponsible people (Matyas, 2006).

Action and decisions of the biggest health care fraud schemes

        The doctors were prescribing knee, shoulder and back braces which were not needed. In the scam not only medical professionals bit also various corporate executives were also involved. The proprietor of medical equipment organizations was giving heavy bribes to the medical professionals so that they can prescribed braces to the individuals who were not needed. The department of health care & FBI worked together to dismantle this Medicare scheme. The FBI & department of health care took action against the CEOs of several medicine organizations. The scheme was being prosecuted through the justice department. In addition  takes part in dismantling the scheme.

        If the whole case is analyzed, then it can be said that the actions that were taken against the scheme were not entirely ethically wrong because the individuals who were miss using the medical profession should be punished. However, the punishment should be given after the individuals are proven guilty. The individuals will remain innocent until proven guilty by the court. It is important to take action against such individuals who have misguided the people about the use of braces. If the action is going to be taken against such organizations than in future occurrence of such issues can be mitigated (Brown, 2010).

Analysis of the biggest health care fraud schemes

            If the whole scenario is analyzed, then it can be said that it is highly important to take action against such an individual who has committed a crime. Action against such individuals is not ethically wrong. However, if the punishment is given to innocent people than this could be an ethical issue. The court can declare someone guilty if the allegation is proved in the court. If they are just mere allegations and anything is not proof against the individuals than it would not be ethical to pursue the case further and give punishment to such individuals.

        The government should take actions and increase the security of health care organizations. If special laws are going to be made regarding the duties of health care professionals than no health care professional will able to perform such activity which leads to harm to the patients. It is highly important for the health care organization to create a strong organizational culture and enhance its internal control. The health care professionals should not work with such organizations which they believe are working against the welfare of the patients. Therefore there is a need to implement strong rules and regulations as well (Kazmier, 2018).

Action Recommendation of the biggest health care fraud schemes

There are some steps which could be considered as the action recommendation for the patients to prevent the fraud health care to ever happen such as:

Make sure to protect and secure your Medicare or Social Security number.

You need to make sure to protect and secure your Medicare or Social Security number and only give them to your liable doctors or your preference medical experts. Be aware if there is anyone asking for your Medicare number or maybe offering some promotion or services if you would give your Medicare number.

Make sure to secure your medical information.

Be careful if anyone other than your doctor or your preference medical expert is asking about the information of your medical records or any records on your medical service as well.

Never accept the medical services that you really do not want or need.

Be careful if any provider is persuading you or even forcing you to any free or low-cost services which actually you really do not want or need.

Try to be skeptical.

Try to be skeptical and careful with any medical promotions which convince you to get any offer within cheap costs.

In the other hand, the action recommendation for the government is that, the government needs to give full attention on the health care system and make sure to prevent this kind of case from occurring again with protecting the rights from the innocent patients to get the access to the health care as well (Fabrikant, Kalb, Bucy, Hopson, & Stansel, 2018).

Summary Argument of the biggest health care fraud schemes

            “The Health Care Fraud Scheme Involving Medicine and Durable Medical Equipment (DME)” case which happened in  has  proven on how fragile the health care system and how the government is unable to protect the innocent patients from getting attacked by this health care fraud scheme. The fact that not everyone could get free access to the health care which provided by the government has made some people would prefer and accept the offer of   from the criminal persons who are using this opportunity and get the benefits from it. This case also has given the presentation on the bad image of the medical specialists nowadays which supposed to give their service for the patients who really need it. Instead, the medical specialists in this case are misusing their skills and capabilities to fool the innocent and disabled patients and get the profits from them. This is definitely considered to be unethical since all the doctors or medical specialists have been taken their vow to practice their skill and ability to serve the patients. For this reason, they should have prioritized on the patients rather than thinking of their own benefits.

            The corruption which performed by the irresponsible and criminal persons in this case is considered as immoral and dying out the ethical groundwork of numbers of people who are still loyal with the honorable profession in the medical field. For this reason, there is a need for action to handle and also prevent this type of case to occur and attack innocent people. In the other hand, the government also must have to support to prevent and handle this case as well. Because with the support of the government, then at least this type of case will able to get reduced from harming the innocent people who really need support in the medical field. The government indeed must to take strict actions as well as figure out on how to increase the security to protect the health care organizations. As I mentioned above, if there would be special laws are going to be made regarding the duties and responsibility of health care professionals than there will be no health care professional will able to perform and practice such activity which able to lead and harm the innocent patients. For this reason, it is considered to be highly important for the health care organization to build, create, and also maintain a strong organizational culture as well as enhance its internal control to make sure that this kind of case would not happen.

        Thus, everything is actually depends on the person as well. In simple words, as a medical specialists which are have taken a vow to serve the patients, then they should able to realize their true responsibilities for the patients and also the consequences that they would get if they misuse their skill and ability within the wrong way or even criminal ways only for their profits. It is all depend on the ethical and the morality of themselves on how they would perform their duties and responsibilities for the innocent patients.