Liability Criminal Liability and Healthcare Organizations Providing

¶ … Liability

Criminal Liability and Healthcare Organizations

Providing the highest quality care possible to patients is of course the overarching goal for any ethically operating medical establishments, and should guide most practices. There are other considerations for medical practitioners and organizations, however, that must also remain present in the awareness, planning, and actions of administrators, physicians, and other personnel. Criminal liability, while not the most pervasive threat in most medical organizations, is still a very substantial risk that must be controlled. The following paragraphs provide some very brief details regarding criminal liability in two specific areas that present real and common risks to most medical organizations in the United States: Medicare/Medicaid fraud and abuse, and the abuse or neglect of patients admitted for treatment.

While most cases of Medicare or Medicaid abuse or fraud on the part of physicians or medical organizations results only in civil penalties, criminal charges have been brought and are certainly possible in egregious and demonstrably willful cases (Taitsman, 2011). Increasing knowledge of specific requirements and limitations on billing for such programs and a regular review of proper practices and billable procedures should occur for all medical and administrative personnel (Taitsman, 2011). In larger organizations, oversight is also an important feature of limiting exposure to criminal liability. Physician and administrator education can help to reinforce principles as well as avoid accidental transgressions, but for an organization to shield itself from individual actions taken by medical or administrative staff there must also be regular reviews of billing and other practices (Taitsman, 2011).

Criminal negligence can come in many forms and as the result of many different areas and types of operations in a medical setting, and while abuse might be fairly easy to determine based on a given set of facts and is almost always willful, negligence is usually much more subtle, difficult to define, and more easily encountered. Again, education is key in limiting the risk of exposure to criminal liability due cases of negligence, as changing regulations continue to expand the reach of criminal prosecution not simply for lapses of judgment or inappropriate applications of ethics and duty, but also for certain classes of serious mistakes that might be made by medical practitioners and organizations (Hurley & Berghahn, 2010). Pharmaceutical mistakes are one area of special and growing concern when it comes to criminal liability arising out of medical negligence, meaning this is one area in which organization-wide educational standards and review procedures should be implemented, and extensive oversight of pharmaceutical use even before such substances are administered to patients, when possible, should be employed to prevent such exposure (Hurley & Berghahn, 2010).