Chapter 6: Individual Factor Moral Prices and values 177 RESOLVING ETHICAL BUSINESS CHALLENGES Dr. Robert Smith owned his family practice for checked files, these charges to Medicald appeared over 20 years. He came from a family of success to increase dating back at least five years. His father was a brain surgeon and his mother Saul approached his brother. "Robert, are well-known author. His younger brother, Saul, you aware you charged Medicald for Mt. and owned his own accounting firm for several years, Mrs. Bennett's visits? but came to work with Dr. Smith after he sold it "Hmmm. Let me see the paperwork, for a modest amount. Dr. Smith asked. Saul handed it to him. Dr. Smith After graduating at the top of his class from glanced at the document and said, "Yes, they are Johns Hopkins University, Dr. Smith was awarded over age 65, so I made a bill for Medicaid a cardiothoracic surgery fellowship in New York. "But we have records they paid you with He spent a few years there and was well on his cash." Saul replied. He handed Dr. Smith an old way to fulfilling his dream of becoming a heart receipt. "And there are similar instances with surgeon. During this time, however, his father some of your other patients. Besides, Medicaid is became ill. Dr. Smith decided to return to his for low-income patients, not the elderly. Mr. and hometown of Zoar, Ohio, to take care him. Mrs. Bennett are clearly not low-income." Under Dr. Smith's care, his father started showing Looking a little bit flustered, Dr. Smith signs of improvement. He was glad not only for replied, "Saul, you know how I am with details. I'm his father, but that he could go back and continue no good at it. That's why I hired you. Thanks for his pursuit of becoming a heart surgeon. On the catching my mistake." Dr. Smith walked back into day he was set to leave, his mother became ill and his office and shut the door, leaving Saul standing died a few days later from a rare form of cancer in the hallway with a stack of files. that showed no symptoms. The devastation hit Saul knew what his brother gave up for their the family hard. Saul was still in college, and Dr. family and the good he did for the families in this Smith's father needed someone to be with him at small town, but he was convinced these charges all times. Dr. Smith decided to stay in Zoar to take were not accidental. There were too many of care of his father. He opened up a family practice them and the amount of money charged exceeded in the town, thus putting his dream of becoming a $75,000. heart surgeon on hold indefinitely. "What happened to all that money?" Saul Over the years, Dr. Smith sometimes felt wondered. He also wondered how to handle regret that he never achieved his dream, but his job the situation. He thought to himself. "How can as the town doctor had been fulfilling. Now Saul I report this without sending Robert to jail? If I was working with him, helping with the business. don't report it and Medicaid finds out, I could go This made things significantly easier for Dr. Smith, to jail and lose my accounting license. This is such who haphazardly kept his own books and patient a small town. If anybody finds out, we'll never live files. One day, as Saul organized Dr. Smith's piles it down." At that moment, the phone rang, and of paperwork, he noticed there were charges to Saul was the only one there to answer it Medicaid that must be a mistake. While most of the population of Zoar, Ohio, was considered low- level income and qualified for Medicaid, this was QUESTIONS EXERCISES not the case for all patients. There were several 1. Describe Saul's ethical dilemma. elderly middle- and higher-income families who 2. Why would Medicare fraud be a white-collar regularly visited the office and usually paid with a crime? check or cash. Saul assumed his brother's admin- 3. How should Saul approach the situation? istrative office skills were poor and almed to fix it. "This case is strictly hypothetical any resemblance to real per However, as Saul organized the paperwork and sons, companies, or situation is coincidental Sigurd Maywea la per. Du Read the attached ethical dilemma and respond to the following questions: 1. Describe Soul's ethical dilemma 2. Discuss Soul's alternatives. What are the consequences for those alternatives? 3. Why would medicare fraud be a white collar crime? 4. If yo were in Souls's place, how would your resolve this dilemma? Identify the ethical framework and the values you used