Medical Care Law

Chapter 3 - Criminal Law Rights And Violations

Highlights

The government routinely prosecutes health care practitioners for criminal law violations.

Criminal cases can result in imprisonment, large fines, and expensive defense costs, which are not paid by medical malpractice insurance.

Criminal defendants have substantial constitutional protections.

Health care practitioners must know the special criminal laws that apply to medical care.

Health care practitioners must know how to protect their rights in criminal investigations.

Introduction

Commonalties In Criminal And Administrative Law

The Constitutional Basis For Criminal Law

Punishment versus Prevention

Constitutional Protections

Habeas Corpus

Bill of Attainder-Ex Post Facto Laws

Trial by Jury

Unreasonable Searches and Seizures

Criminal Actions-Provisions Concerning-Due Process of Law and Just Compensation Clauses

Rights of the Accused

Bail-Punishment

Applying The Constitutional Protections

Specificity Requirements

Right to Counsel

Privilege against Self-Incrimination

Searches and Seizures

Standard of Proof

Double Jeopardy

Investigation Of The Criminal Case

Prosectorial Discretion

The Citizen's Duty

Protecting Your Rights

Federal Fraud Prosecutions

The Prohibited Transactions18

The History of Enforcement

The Constitutionality of the Laws

The Everyone-Does-It Defense

False Claims Act

Risk Management Issues

Waiving Deductibles and Copays as Fraud34

Waiving Copays

Discounts

"No Charge"

"Kickbacks" and Inducements To Refer Patients

Penalties

Antitrust Laws

Market Share

State Action Immunity

The Federal Trade Commission

Technical Fraud: Rico Violations

Understanding RICO

Mail and Wire Fraud

Incentives and Commercial Bribery

The Pattern of Racketeering

Prosecuting a RICO Claim

The Federal Sentencing Guidelines And Compliance

Sentencing Implications for Health Care Practitioners

Abuse of Position of Trust or Use of Special Skill

Commentary

Compliance Plans

Sentencing Guideline Standards for Compliance50

Special Characteristics of the Organization51

Considerations for Physicians

Implications for Health Care Practitioners

References

Suggested Readings

Appendix 3-A - Responding To Government Investigations

PURPOSE

POLICY

PROCEDURE

Request for Interview

The Search