A private healthcare system has one inherent conflict–money. When individual caregivers and facilities receive payment for the specific services they render, and patients almost always agree to the doctor’s recommendations about needed services, there is a risk of medical decisions being influenced by a drive for profit.
Recognizing this reality is not an automatic indictment of any specific caregiver. But, at the very least, it is critical that we recognize this risk and take steps to guard against it.
Chicago Medical Malpractice & Fraud
One need not look far for a local example of how this conflict can play out with deadly consequences. As discussed by many major media outlets this summer, several individuals at a Chicago hospital are now facing criminal charges after allegedly ordering unnecessary tracheotomies on patients in order to receive the sizeable payment for the procedure.
A tracheotomy is not minor treatment or test. The procedure includes make a cut on a patient’s neck and opening a hole in the trachea or windpipe. Essentially, this is used for those who are not able to breathe through their nose and mouth. It bypasses that entirely by providing a way for air to enter via the incision made in the neck. Obviously this can be a critical step for those who need it. But if a patient is able to breathe normally, there is absolutely no reason to take this drastic action.
Unfortunately, if the claims made against those at Sacred Heart are true, then that is exactly what happened.
FBI officials who investigated the matter suggest that at least one doctor intentionally kept patients too sedated to breathe on their own. This spurred the use of tracheotomies, which netted the facility upwards of $160,000 in revenue for each procedure.
Criminal & Civil Charges
Not long after these problem came to light, several doctors allegedly involved in the scheme were hit with a federal criminal complaint. Among other charges, the named-defendants all allegedly conspired in the scheme to defraud Medicare and Medicaid while physically harming patients.
Millions were apparently siphoned from public coffers to pay for this unnecessary care. Not only that, but lives may have been lost as a result. The complaint explains that during a two and a half year period, over 28 tracheotomies were performed, with five patients dying as a result That death rate is 300% higher than the expected rate in Illinois.
The conduct alleged in this case represents a staggering breach of trust. When the Medicare and Medicaid programs are defrauded in this manner, everyone in the community suffers. That is, of course, on top of the very real physical harm that befalls those whose medical care is influenced by doctor profits.
Sadly, the only way that much of this misconduct comes to light is when whistleblowers stand up and demand changes. Our attorneys is proud to work with whistleblowers and others with information about Medicare or Medicaid fraud in Chicago, Illinois and throughout the country. Please get in touch with our team if you think we can help.
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