The Federal Sentencing Guidelines apply to institutions as well as individuals. If
an institution such as a hospital or clinic is run in a criminal manner, the
individual employees and officers of the institution can be sentenced to prison
and fined as individuals and the institution itself can be fined. The fines can be
statutory fines designed to punish the institution or they can be based on the
value of the illegal benefits with the intent of depriving the institution of ill-
gotten gains. If the government finds that the institution was run as a criminal
enterprise—if the reason for the existence of the enterprise is its criminal
activity—the fines will be set high enough to destroy the institution. The level
of the fines and, indirectly, the culpability of the officers of the institution
depend on its ability to show that it tried to obey the law and was the victim of
unpreventable fraud by certain employees. The Federal Sentencing Guidelines
have set standards for evaluating the intent of the institution. These are
important to medical care practitioners because the OIG now requires all
hospitals and many other medical care institutions to have plans to ensure that
the institutions comply with the relevant federal laws. These are generically
known as “compliance plans.” The OIG requirements are based on the
standards of the Federal Sentencing Guidelines. Medical care practitioners will
have to implement these plans as administrators and will have to abide by
them as practitioners. Failure to do so can be considered evidence of criminal
intent.