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  • Essay / Georgia State Medicaid Whistleblower

    Many use the term whistleblower to describe employees who report misconduct or abuse of authority to the outside world. Whistleblowers do so because they don't believe their company will handle the problem properly or because they are angry or dissatisfied after their struggle to report unethical behavior or abuse of authority is deemed ineffective (ERC, 2012). They are ultimately torn between their loyalty to their employer and their moral responsibility to the law. Description: The case of Chief Financial Officer Ralph Williams, who, shortly after his employment with Health Management Associates, discovered a scheme to defraud the State of Georgia's Medicaid program. . Dallas-based Health Management Associates and Tenet Healthcare and their affiliates referred pregnant women living in the country illegally to for-profit hospitals run by HMA and Tenet in exchange for bribes following fraudulent Medicaid applications . The Medicare and Medicaid Patient Protection Act, known as the Anti-Kickback Law, prohibits paying or accepting money to arrange for medical treatment under government-funded programs federal. Williams also alleges that Tenet used a similar system at several of its hospitals. Shortly after Williams raised concerns about the fraudulent arrangement with company executives, he was fired without reason. These hospitals paid bribes to Clinica, disguised as payments for interpreter services, to funnel emergency Medicaid patients to them and increase their bottom lines (Brumback, 2013/01/08). Federal court for violating the Medicaid law's anti-kickback statute. They may also be required to pay substantial fines to the State of Georgia. The S...... middle of paper ...... wrote my resolution using. the ethical problem solving model. I used a combination of virtue, principle, and results approaches to explain my resolution. It is the responsibility of the CFO to do what is in the best interest of the common good. It is up to the financial director to maintain a healthy relationship with his employers and to avoid any risk of reprisals, by practicing the art of anonymous activism (Svara, 2007, p. 121). References Brumback, K. (2013/ 01/08). Whistleblower lawsuit: Hospitals defrauded Medicaid. The United States Today. Retrieved from: http://www.usatoday.com/search/whistleblower/Ethics Resource Center. (05/31/2012). What is a whistleblower? Retrieved from: http://ethics.org/news/2011nbes-reporting Svara, J. (2007). The ethics guide. Sudbury, MA: Jones and Bartlett Publishing