Lessons from the ‘legitimate’ misuse of Medicare Benefits Schedule Item 45503
Jonathon Bruce Ryan
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Abstract
This Perspective begins with a case study that raises two important questions: who is responsible for the existence of non-compliant Medicare billing, and who is responsible for eliminating it? In the discussion that follows, I argue, first, that the problem has been created by individual clinicians and by Medicare itself (i.e. the organisational structure that administers Medicare). Second, and more importantly, I argue that the ethical obligation to eliminate the problem extends more broadly to include both the government and the medical profession.
Keywords: ethics, governance, healthcare fraud, health funding and financing, health policy, Medicare, Medicare Benefits Schedule, organisational culture.
References
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