More on hospital fraud

So, folks, a lot of you were stirred up by my recent column on fraud. The people who responded, generally speaking, seem not to agree that fraud is more or less the same that it's always been. In fact, many of you seem extremely pessimistic about the hospital industry and angry about what you perceive as unfair practices. Some of your comments include the following:

"I am very disappointed with this opinion piece on fraud committed by healthcare. It seems that you are saying that these people are really very ethical but are "forced by the system" due to economic pressures. Thievery is thievery; it is unethical, and no excuses [should be made]. Particularly when it is committed by a group who hold themselves as holier than thou who only work to serve the common good. Everyone faces these challenges in their daily lives." - M

"I think there is seriously more hospital fraud now than in the past. To some extent it is fostered by the ridiculously overregulated health care marketplace, which encourages, led by our own government, to cost shift. Therefore, overcharging is already justified as the cost of being a hospital. Second, as not for profit health care systems have transferred their management from vow of  poverty managing nuns, for example, to secular non vow of poverty suits, they have figured out there is money to be made in hospitals by pleading poverty, ruthlessly and immorally stamping out more competitive healthcare delivery models by accusing the competition of cherrypicking (Huh! Cherry picking by doctors, when hospitals routinely mark up their costs from 400-1600 percent." - JC

All I can say is that I don't dispute that there's plenty of opportunities for fraud, and that at least some folks are taking advantage of them. Meanwhile, I'd like to note that in describing the pressures hospital admins face, I am by no means suggesting that I'm excusing questionable behavior, much less fraud. I'm just noting that human nature being what it is, it would surprise me if people didn't make more ethical mistakes.

Make no mistake, I'm going to keep a tough eye on hospital fraud, and keep reporting on how it happens. In the mean time, keep me up to date, folks. Most bad practices aren't as common when they're exposed to bright sunlight. - Anne

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.