Health Management Associates

Working in the medical field requires that constant, quick, and ethical decisions are made every day to save peoples lives. We, as vulnerable patients who enter clinics or hospitals trust that our medical providers act with out best interest in mind. We trust that our doctors hold true to the ethical pledge they made when they became medical professionals. Unfortunally, this is not the case with Health Management Associates, LLC (HMA). In this paper I will discuss the unethical decision made by this organization, ethical considerations.

those affected by those decisions, and evaluate why HMA did not act ethically as well as things they could had done differently.

Introduction

According to the Department of Justice and Yahoo, between 2008 and 2012 Health Management Associates intentionally billed insurance companies for inpatient services that should have been billed as observation or outpatient procedures, as well as submitting overstated claims for emergency department fees. These are a series unethical decisions and action from the nurses, billing staff, doctors, medical directors, and other medical staff.

In trying to make “quick and easy money”, these medical staff brought radical consequences upon not only this hospital chain but the whole medical system. Everything about these events is so unethical that it would be easier to describe the ethical considerations that where not evaluated but should had. According to the AMA Principles of Medical Ethics, physicians promise to maintain the standards of professionalism, be honest in all professional dealings, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.

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During 4 years, this whole hospital system defrauded patients, the government, insurance companies, and honest medical providers. The hospital staff co-conspired with each other at the cost of others. Another ethical consideration should had been patients trust. Physicians recognize a responsibility to put patients well being first. When a hospital acts in a way that breaks patients trust, those patients are hesitant or deterred from seeking life altering or saving treatment. When populations of people don’t trust and seek medical attention lives are at risk. A third consideration again from the AMA would be “A physician shall respect the rights of patients, colleagues, and other health professionals”. The medical staff members who acted unethically, did not consider how their actions would affect those that made ethical decisions. Many peoples incomes, livelihood, reputation were at stake because of the decisions of those who choose to break the law.

Report Body

A magnitude of lives were affected by these decisions. The most obvious stakeholders affected by these actions are the patients, we put our lives in the hands of others expecting that our lives are just as precious to them as it is to us. This affects patients in ways that snowball out of control. For example, I might not go to the doctor if I hurt my knee causing me to have health problems for years to come or I am left with a distrust for medical professionals that will in fact affect my health choices and that of my family. Insurance companies are another stakeholder that is affected because the industry has been abused, thus will have to be more vigilant when dealing with medical providers. A third group of stakeholder affected are medical staff. Not only were the ethical doctors affected but also some of the ones that acted unethically. According to the Department of Justice, “HMA pressured emergency room physicians, including through threats of termination, to increase the number of inpatient admissions from emergency departments—even when those admissions were medically unnecessary”

In an effort to act more ethically, the organization will pay a $216 million settlement. And according to Yahoo, immediate steps to remove HMA’s Board of Directors and senior executives and to integrate HMA affiliated hospitals into the Community Health Systems compliance program were taken. Although these 3 actions are helpful, the organization should had continuous audits, ethical training. Another things that the organization could had done differently is provide a safe environment where unethical and illegal actions could be reported.

Conclusion

I think that it is unfortunate that this happened in such a massive scale in this country. The health care industry already has a bad reputation in this country. Health care professionals are supposed to prioritize their patients’ lives. When profit becomes the motive, to the point where multiple federal laws are being broken and medical professionals are being threatened termination, trust in the industry lost. Trust in medical services is essential for the welfare of our communities. We want to know that we can trust hospitals with our lives. Ethics are important, not only in this case and industry but also in our every day lives and jobs.

Bibliography

1. Department of Justice. (2018, October 1). Hospital Chain Will Pay Over $260 Million to Resolve False Billing and Kickback Allegations; One Subsidiary Agrees to Plead Guilty. Retrieved from https://www.justice.gov/opa/pr/hospital-chain-will-pay-over-260-million-resolve-false-billing-and-kickback-allegations-one

2. Global Settlement Resolves U.S. Department of Justice Investigation Into Health Management Associates, Inc. and Related Affiliates. (2018, September 25). Retrieved from https://finance.yahoo.com/news/global-settlement-resolves-u-department-214000177.html

3. Code of Medical Ethics overview. (n.d.). Retrieved February 01, 2019, from https://www.ama-assn.org/delivering-care/ethics/code-medical-ethics-overview