Resolving Ethical Business Challenges- Using the SEVEN-STEP CASE ANALYSIS METHODOLOGY TO EVALUATE THIS CASE. (be sure step 4 is being used for pros and cons) ??

After graduating at the top of his class, Dr. Roberto Hernndez was awarded a cardio thoracic surgery fellowship in New York. He spent a few years there and was well on his way to fulfilling his dream of becoming a heart surgeon. During this time, however, his father became ill. Dr. Hernndez decided to return to his hometown to take care of him. Under Dr. Hernndezs care, his father started showing signs of improvement. On the day he was set to return to work, his mother became unexpectedly ill and died a few days later. The devastation hit the family hard. Dr. Hernndezs sister Alicia was still in college, and his father needed someone to be with him at all times. Dr. Hernndez decided to stay in his hometown to take care of his father. He opened up a family practice in the town, thus putting his dream of becoming a heart surgeon on hold indefinitely.

Dr. Hernndez owned his family practice for more than 20 years. His younger sister, Alicia, owned her own accounting firm for several years but came to work with Dr. Hernndez recently after she sold the firm for a modest amount. Over the years, Dr. Hernndez sometimes felt regret that he never achieved his dream of becoming a surgeon, but his job as the town doctor had been fulfilling. Now Alicia was working with him, helping with the business. This made things significantly easier for him. One day, as Alicia organized Dr. Hernndezs documents and patient management system, she noticed all his patients were on Medicaid. While most of the population of the town qualified for Medicaid, this was not the case for all patients. She knew of a number of families who regularly visited the office and usually paid with check or credit card that were not on Medicaid. Alicia assumed her brothers administrative office skills were poor and aimed to fix it. However, as Alicia organized the paperwork and checked files, the overall charges to Medicaid appeared to increase, dating back at least five years.

Alicia approached her brother. Roberto, are you aware you charged Medicaid for Mr. and Mrs. Bennetts visits?

Hmmm. Let me see the documentation, Dr. Hernndez asked. Alicia handed the tablet to him. He glanced at the figures and said, Yes, they are over age 65, so I billed Medicaid.

But we have records they paid you with cash, Alicia replied. She tapped on the screen to show the receipts. And there are similar instances with some of your other patients. Besides, Medicaid is for patients with limited income, not the elderly. Mr. and Mrs. Bennett, as you know, are not low-income patients.

Looking a little flustered, Dr. Hernndez replied, Alicia, you know how I am with details. Im no good at it. Thats why I hired you. Thanks for catching my mistakes. With that, he walked back into his office and shut the door, leaving Alicia standing in the hallway with a stack of files.

Alicia knew what her brother gave up for their family and the good he did for the families in this small town, but she was convinced these charges were not accidental. There were too many of them, and the amount of money charged exceeded $75,000 per year as well as the problem with Medicaid.

What happened to all that money? Alicia wondered. She also wondered how to handle the situation. She thought to herself, How can I report this without sending my brother to jail? If I dont report it and Medicaid finds out, I could go to jail and lose my accounting license. This is such a small town. If anybody finds out, well never live it down.