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The Whistleblower Of The State Of Georgia Medicaid Program

682 words - 3 pages

Many use the term whistleblower as a way to label employees who externally report misconduct or abuse of authority. Whistleblowers do it because they don’t believe their company will manage the matter properly or because they are enraged or unsatisfied after their struggle to report unethical behaviors or abuse of authority is deemed ineffective (ERC, 2012). They’re eventually torn between loyalty to their employer and their moral responsibility to the law.
Description:
The case of chief financial officer Ralph Williams, who soon after his
employment for Health Management Associates, uncovered a scheme to defraud The State of Georgia Medicaid Program. Health Management Associates and Dallas-based Tenet Healthcare and their affiliates referred pregnant women living in the country illegally to for-profit hospitals operated by HMA and Tenet in exchange for kickbacks from fraudulent Medicaid claims. The Medicare and Medicaid Patient Protection Act, known as the anti-kickback statute, prohibit paying for or accepting money to arrange for medical treatment under federally funded programs. Williams also alleges that Tenet used a similar scheme in a number of its hospitals. Soon after Williams, voiced his concerns about the fraudulent arrangement to company leaders he was fired without reason. These hospitals paid Clinica kickbacks camouflaged as interpreter service payments to funnel emergency Medicaid patients their way and increase their bottom line (Brumback, 2013/01/08)."
Assess of stakeholders:
Health Management Associates, Tenet Healthcare and their affiliates can be charged in Federal court for violating the anti-kickback statute of Medicaid law. They can also be made to pay substantial fines to the State of Georgia. The State of Georgia may be affected by an increase in the cost of the overall Medicaid program which poses a threat to the quantity of services provided through the Medicaid program. The Chief Financial Officer may be affected by risking integrity, credibility, and his career.
Analysis:
The virtue based approach looks inward at the qualities; “what would a good person do?” A good person would be honest by breaking his silence and report...

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