The Whistleblower of the State of Georgia Medicaid Program

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Recommended: Two pillars of ethical leadership

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 S...

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...ed my resolution by using the ethics problem-solving model. I utilized a combination of the virtue, principle and results oriented approaches to explain my resolution. It’s the responsibility of the chief financial officer to do what is in the best interest of the greater good. The greater good would be for the chief financial officer to maintain a healthy relationship with his employers and avoid any and all of risks of retaliation, by practicing the art of anonymous activism (Svara, 2007, pg., 121).
References
Brumback, K. (2013/01/08). Whistleblower suit: Hospitals defrauded Medicaid. Usa Today. Retrieved from: http://www.usatoday.com/search/whistleblower/
Ethics resource center. (2012/05/31). Just what is a whistleblower? Retrieved from: http://ethics.org/news/2011nbes-reporting Svara, J. (2007). The ethics primer. Sudbury, MA: Jones and Bartlett Publishing

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