Corporate Compliance and Maintaining Ethical Business Relationships
The ethical foundation of every company is a significant approach in which such companies are perceived by customers as well as peers. The moral foundation acts as the source of self-respect and pride of a given company. Most business ethics are subjective and depends on other factors of the business context of the business as well as the principle which governs the type of business to be conducted. In most cases, the ethical business relationship is usually viewed as reduced legal compliance to business activities as most activities involved in such operations are individual or business based. However, the payment mode is the most point of concern which enterprises are faced with especially in attempts to keep steady track to their services. In the United States, Medicare services have been in most cases faced with different challenges during payment modes which the physicians are subjected to after laboratory test services without suffering Medicare frauds. The application of court in these services as a means of solving payment issues has adversely shaped the relationship between defendants and the physicians. This paper focuses on discussing the corporate compliance nature regarding cases which are usually common in the Medicare services and upholding ethical business associations concerning throughout the transaction process. It also captures the facts in United States v. McClatchey and United States v. Greber in the payment modes which are used in such business activities.
United States v. Greber
Greber (defendant) who was a physician established the Cardio-Med business which provided medical devices to the physicians for recording the cardiac activity of patients on a tape. The defendant, Greber later sought financial repayment from Medicare for the medical services to all qualified patients as well as provided physician who is referring patients with an option of using the device during the process. Notably, Greber claimed that the physician who is offering referrals had provided “interpretation fees” regardless of the amount which had been evaluated by the Cardio-Med device data. The forty percent fee, which is physicians received as a sign of payment, was above the Medicare requirements. Before the civil proceeding in the jury appeal, Greber had made a testimony that all doctors must get a consulting fee to be accepted in their services or any related activity within their jurisdiction. According to the records from the Cardio-Med’s billing, it can be noted that Greber was charged by the federal government for providing financial kickbacks to physicians offering referral which is viewed as a violation of the rule of law as well as the “Anti-Kickback” statute.
On trial, the jury was instructed by the distinct court judge that it was the duty of the government to ensure that the amount paid to the physician as well as the one received from Medicare meets certain limit (Maritz & Gerber, 2017). However, this was further asserted that if the defendant willfully or knowingly caused Cardio-Med in making payments, he only does so as a way of inducing physicians to maximize the use of Cardio-Med’s services. If a physician interprets the test of the patient as a consultant of a Cardio-Med, the judge is mandated to make charges regardless of the purpose of the referral fees which was used in inducing service from the Cardio-Med. Overall, Greber was found guilty by the jury. The post-trial motions were later denied as the defendant appeals.
United States V. McClatchy
In this case, Dennis McClatchy was majorly convicted by the jury of a scheme of sacrilegious the Medicare Anti-Kickback Act. McClatchey was accused of offering and disbursing bribes for the recommendation Medicare as well as Medicaid-eligible nursing to Ronald LaHue and Drs. Robert is against the requirement of the rule of law. In response, Mr. McClatchey’s motion was granted by the court for a judgment of acquittal after it was realized that the available evidence for the trial was never enough to support the conviction against any crime. The Tenth Circuit was reversed to hold that the evidence must support an inference which is reasonable on Dennis McClatchey cases before negotiation and contract are made to rationalize the entire process (SmithBattle, 2018). The parties involved in the jury also held several objections, but after the court made a telephone conference, it was evident that a procedure for ruling and briefing must be availed in conjunction with additional evidence during the sentencing hearing. However, it became clear that the ruling which is being made by the court is usually final and not only exposes the defendant to the final verdict but also help the court in making a concrete verdict based on the offense conduct.
Interestingly, the defendant can object the offense conduct descriptions if the information of the major particulars of the case are not enough or is being used as a measure the impact of the rule of law. Moreover, the Tenth Circuit decision acted as the most valuable aspect in defining the factual findings of the court based on the legal conclusion which it uses in supporting the jury beyond any reasonable doubt (SmithBattle, 2018). However, the objections made by the government against the offense conduct description are associated with false conclusions in findings and facts about the case. Appropriate guidelines, as well as the calculation of the value of the bribe, should be done with inclusions of all the money paid to other parties before a conclusion about the case is made.
Greber Payments for Professional Services
Greber payments were majorly for permissible purposes, though Physician was using them for inducing major referrals. The induction into referral is usually regarded as a violation of the rule of law which stipulates that all payments were made for professional services would be subjected to major conditions as opposed to the erratic assumptions in which people are subjected to. According to the rule of law, the payments for professional services and remuneration have monetary value and should be treated with a lot of care without interfering with the entire jury process. Similarly, Greber payments for professional services are associated with Kickbacks which are used to encourage most of the referral works. The kickbacks were majorly in the form of long term credit arrangements, cash, supplies, gifts, and equipment as well as business machines. Notably, the defendant is a renowned oestophic physician as well as a member of the certified board in cardiology. He is provided with diagnostic services by the company such as Holter-monitor which is being worn for twenty-four hours and is used for recording the cardiac activities of the patient on a table among others. The plaintiff (government) charged the Defendant, Greber with Medicare fraud, which is based on a violation of the rule of law. Most of the charges from the appeals stemmed from the Cardio-Med are practices which involve paying kickbacks from the funds generated from the Medicare funds to the referring physicians for the maximization of future referrals. However, the respondent argued that all the payments which he received were for the performed work which the physician did as well as that for future referral, which was regarded as the only purpose for such payments.
Greber payments for professional services also involve major contentions which are not to rectify the dimming approach but also to ensure that the overall application is subjected to the main point of concern. Interestingly, in the payment, the physician is limited to certain activities which are pertinent to the patient’s welfare. The limits are majorly and barely restricted to particular outlines within the physician jurisdiction and the intended referrals (Chung, 2018). The main issues in the appeal are the illegality of the payment, which was made to a referring physician if the process was done to heighten future referral regardless of the nature of the made amount. The appeals were held and maintain that all the payments which are made to a referring physician in contrary to the rule of law are regarded illegal if it aims at encouraging future referrals. Besides, if Medicare is involved in the process, no payment, compensatory or gratuitous of any kind and nature can act as a way of securing referrals. But for a violation to be evident in the Medicare process, references are compared to a factor rather than a reason for payment. The charge against the jury, in this case, was the leading cause of errors in the entire appeal.
However, the failure of Dr. Greber percentage payment to exceeded Medicare guidelines could have halted the identification of the payment done. In most cases, the guideline acts as the lead spot or reference point where most corrections and directions are generated from especially the ones which are related to the referral. As a result, if the payment made to the physician either as consultation fee or for the referral doesn’t exceed the guideline, it can very hard to make identification (Chung, 2018). Besides, other bodies can be used to help in measuring the extent with which certain payment is made based on the code of conduct as stipulated in the rule of law. Over and above the guideline also interferes with the government requirements thereby exposing the entire service delivery to stunt progress as the physicians try to cope with the stipulated codes of conduct and behavior based on the valuable concerns are subjugation. Overall, if the Medicare percentage is exceeded, referrals are faced with many legal restrictions, which requires that the physician concerned or involved in the process honors the jurisdiction with obvious concern not merely perception. The rule of law also helps in making conclusive supposition in referring patients at an affordable fee.
The legality of Perk Service Provided by Hospitals to Physicians
Most hospitals ensure that their physician gets extra services as opposed to their monthly payments for services rendered. The services they get varies depending on the position held by the physician, his background, importance of the service on his or her wellbeing both within or outside the institution as well as the impact of the service to his or her family members. Stevens (2017), the perk services provided by hospitals to physicians are free meals, preferred parking, as well as discounted medical care for them and their families (Stevens, 2017). However, the services are faced with legality concerns which determine their importance to both the physician and the hospital at large.
According to the rule of law and the stipulated code of conduct which governs the services and wellbeing of physicians, perk services are limited to particular limit and are based on the essential concerns and impacts which they have on the entire process of service delivery. Every government has a limit which is needed to be observed in providing such services, and the amount is based on the impacts of these services to the wellbeing of the physician. The “line” in the perk services portrays the relationship which such practices has in the Medicare provision as well as the overall shape up of the hospital activities.
Additionally, the extent of perk services which are given to physician depends on their service output. In most cases, physicians are exposed to constant practices which require a composed mind and well maintain lifestyle. Therefore, the services must be able to satisfy them as well as make the capable of remaining focused in their entire service delivery. The hospital must ensure that the services are made available to them at the right time, correct amount, and affordable requirements.
United States v. Bernard L. Madoff
The seventy-one-year-old Madoff pleaded guilty of fraud, money laundering, theft and perjury among eleven counts which are related to the establishment of the Ponzi scheme (Manning, 2018). The scheme allegedly resulted in the loss of millions of funds which were mainly for the clients. Madoff’s projected life expectancy, which was approximated to more ten years, and other facts were the main turning points which led to a twelve years sentence. Notably, the one hundred and fifty years a maximum sentence, which was stipulated in the guidelines for the federal sentencing was easily and adequately sorted by the Government (Manning, 2018). However, it became evident that symbolism was useful in retribution and deterrence of primary contexts while identifying a meaningful criminal sentence procedure.
Bernard L. Madoff case v. Greber and McClatchey case
Bernard Madoff was adversely different from both the Greber’s and McClatchey’s. In Greber’s, the subjugation was based on the payment, which was made to the physicians and referrals. The payment was majorly to address Medicare services. McClatchy, on the other hand, focuses on the kickbacks which physician gets from the Medicare services offered. However, Madoff’s cases, though was associated with fraud, it was based on the Ponzi scheme orchestration where massive client’s funds were lost as the process progresses towards the higher position. Although he pleaded guilty to the numerous counts of frauds, theft and money laundering, the use of symbolism was significant in deterrence and retribution of proper criminal sentence contexts especially if the process is to be chosen in the judicial practices.
Additionally, Greber argued that it is not illegal for a patient to be induced during refers though a certain amount of legal fees is paramount for evaluating data in the Holter monitor. The records from the court do not indicate the number of consultants’ fees as compared to what would be paid to the cardiologist for retaining and analyzing the data as ordered by the Holter monitor. Evidence also shows that some physicians who receive consulting fees during the Holter monitor data evaluation by Greber are often affected by the rule of law as well as other unknown jurisdictions. However, mentioning the Greber’s testimony in the government’s case concerns the civil suit, which can only be identified through testing the doctors who have gotten the consulting fee and those who have not. The relationship shows if the payments for Medicare services were majorly preferred for the use of Cardio-Med’s which has been induced by the physician in medical activities, the statute was adversely violated regardless of the intention of the payment. However, as compared to another case, Greber’s shows the court can only convict the jury if he or she is found to have made payments in contrary to the attributable requirements. The ruling affirms that the prohibited means could be the only possible way of making payments which are accompanied by referrals regardless of the mode of transaction which is taking place between the physician and the patient to be served.
Effect of the Health Care Reform Laws of 2010 on Payment and Referrals
Health Care Reform Laws of 2010
The 2010 health care reform, or sometimes referred to as the ACA, was majorly enacted to ensure affordable health insurance to more people across the United States. It majorly focuses on the provision of premium tax credits it consumers to lower household cost with incomes, which varies depending on the level of the federal poverty. The law also aimed at expanding the Medicaid program to ensure that adults whose incomes are below a given percentage of the federal poverty level area adequately sorted and restored. Similarly, the act supports innovative medical service methods which are designed to reduce health care cost across several practices.
However, on payment methods and referrals, the reform offers several integrated protections, “Patients’ Bill of Rights,” which covers various services to the patients regardless of the underlying fee. The act ensures that all patients have the right to access and choose their preferred doctors in either public or private institution (Butler, 2016). Similarly, based on the rules within the standard codes that govern the welfare of patients, the act ensures proper coverage of patients who are suffering from pre-existing conditions are required emergent attention or referral. Greber’ case dictates that all the payments made for the services offered by the physician must be within the rule of law and must address important issues which are related to preventive measures. Therefore, the act ensures that the right to appeal on the health plan decisions is directed towards a common goal to end all the annual and lifetime limits, which usually hinder the success of Medicare service provision. On the other hand, McClatchy case shows that kickbacks are crucial in creating a regular Medicare service. As a result, the ACA act ensures the affordability of healthcare insurance as well as their universal access to minimize dependency on government regulations in determining the actual rationale (Butler, 2016). Overall, the reform improves adequacy in coverage and care for maximization of national standards to achieve essential healthcare benefits.
Paul Tillich’s Theology
Ethical foundation in business is the source of self-respect and pride, which is embraced to ensure corporate compliance as well as maintains the ethical relationship in of a given company. Most business ethics are subjective and rely on the context of love, justice, and power to govern their performance in the operational context. Paul Tillich’s theology asserts that in all spheres of thinking, a problem must usually appear to ensure an accurate picture of the intended meaning and reason as adopted by the parties concerned. According to Tillich, the human being is marked with the certain social condition of existences (Smith, 2017). As a result, estrangement from the rest of people usually exposes one to massive undoing, which in turn jeopardizes their ethical behavior. Love is central in ensuring a steady correlation between the governing body and the Medicare practitioners, and the availability of power elements makes the whole system cohesive and stable.
Tillich further argues that power in ethical business and corporate compliance relationships in nebulous and its potentiality only exist through an extensive encounter with people from other walks of the world. The reality of power is usually realized in the confrontations which it is engaged in for constant affirmations of social interaction for a cohesive ethical celebration (Macleod, 2017). Compulsion in power is associated with the creation of an explicit relationship between several individuals within all social lives across the world. Interesting, Tillich’s theory shows that an individual’s efforts can be measured based on the actualizations of power among people. In healthcare practices, Tillich’s theory serves as a steer that directs the practices which are being adopted by the rule of law and the physicians in asking for consultancy fee or making referrals as stipulated in the rule of law. Moreover, methods of correlation show that insight differs from Christian revelation and defines all issues which are raised by the philosophical, existential, and psychological analysis. The theology state that human existence is determined by issues which are within or outside his or relationship with nature and its inequities.
In conclusion, in the Greber’s appeal versus United State, the payments which the physicians get for the laboratory services which they provide cannot be used as the basis of the fraud in Medicare mainly if the relationship between them portrays a common goal. The assertion further reiterates that holding payment purpose was introduced to induce future referrals, which can be evident if the status of Medicare has been adversely violated. According to the rule of law, it was apparent a payment which has been made to any referring physician is illegal especially if the process is done as a way of reassuring future referrals regardless of the mode of payment deployed. However, in United States V. Mcclatchey, the appeals court realized that evidence that was being used to support the inference of the case could never be used to make the negotiation a success. Instead, it induced a concept of contract entrance with intent to make Baptist be a nursing home for patients. On riling, the appeal court ruled that several mistakes were made by the district court while trying to make clear the jury and determine the root cause. The rejection of the appeal shows the perk services which are being provided to a physician have limits and must be made available if the hospital has offered to so. The services help in reducing tension among physicians as well as the entire court of appeal as it shapes the corporate culture that must be adopted if a particular relation has to be maintained in the Medicare field. Overall, Tillich’s theological theory observes that love, justice, and power are essential in creating a steady correlation in ethical business practices.
Butler, K. H., (2016). Stark law reform: Is it time. Journal of Health Care Compliance, November–December, 5-14.
Chung, Y. (2018). Keeping the healthcare industry accountable. J. Nat’l Ass’n Admin. L. Judiciary, 38, 280.
Macleod, A. M. (2017). Routledge revivals: Paul Tillich (1973): An essay on the role of ontology in his philosophical theology. Routledge.
Manning, P., (2018). Madoff’s Ponzi investment fraud: A social capital analysis. Journal of Financial Crime, 25(2), 320-336.
Maritz, M. J., & Gerber, S. C. (2017). Construction works defects liability before and after the issuing of the completion certificate. THRHR, 80, 27.
Smith, A. A. (2017). Paul Tillich’s Systematic Theology. In Animals in Tillich’s Philosophical Theology (pp. 29-87). Palgrave Macmillan, Cham.
SmithBattle, L., (2018). 4 Teen mothering in the United States: Fertile Ground for Shifting the Paradigm. Re/Assembling The Pregnant And Parenting, 75.
Stevens, R., (2017). Medical practice in modern England: the impact of specialization and state medicine. Routledge.