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1Discipline of Surgery, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
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.
Insights
Non-compliant Medicare billing arises from both individual clinicians and the Medicare system. Eliminating this issue is an ethical duty shared by the government and the medical profession.
Area of Science:
- Healthcare policy
- Medical ethics
- Health administration
Background:
- Non-compliant Medicare billing presents a significant challenge.
- Determining responsibility for this issue is complex.
Purpose of the Study:
- To identify the parties responsible for non-compliant Medicare billing.
- To establish the ethical obligations for rectifying this problem.
Main Methods:
- Case study analysis.
- Ethical and policy discussion.
Main Results:
- Non-compliant billing stems from individual clinicians and the Medicare organizational structure.
- Responsibility for resolution extends beyond clinicians and Medicare.
Conclusions:
- Ethical obligation to address non-compliant billing involves the government.
- The medical profession shares the responsibility for eliminating non-compliant billing practices.
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