Dr. Doyle E. Campbell, an ophthalmologist, established his practice in southern Ohio in 1971. Many of Dr. Campbell’s patients are elderly people who qualify for federal Medicare benefits and state Medicaid benefits. Under the existing financing system, a doctor who treats a Medicare patient is required to submit a “Medicare Health Insurance Claim Form” (HCFA Form 1500). The doctor is required to certify that “the services shown on this form were medically indicated and necessary for the health of the patient and were personally rendered by me or were rendered incident to my professional service by my employees.” Claims Dr. Campbell submitted for his elderly patients ranged from $900 to $950, of which $530 to $680 were covered by the Medicare program. The government alleged that Dr. Campbell billed Medicare for several treatments that were either not performed or not necessary. 1 - Provide a paragraph with more than five sentences (i.e., in the section for “Purport”) that interprets the theme of the case, based on concepts learned 2 - What was the specific violation committed by Dr. Doyle E. Campbell? 3 - If Dr. Campbell were to be held legally liable, would his case be heard in what court and in what jurisdiction? 4 - Against who has the violation taken place?
Dr. Doyle E. Campbell, an ophthalmologist, established his practice in southern Ohio in 1971. Many of Dr. Campbell’s patients are elderly people who qualify for federal Medicare benefits and state Medicaid benefits. Under the existing financing system, a doctor who treats a Medicare patient is required to submit a “Medicare Health Insurance Claim Form” (HCFA Form 1500). The doctor is required to certify that “the services shown on this form were medically indicated and necessary for the health of the patient and were personally rendered by me or were rendered incident to my professional service by my employees.” Claims Dr. Campbell submitted for his elderly patients ranged from $900 to $950, of which $530 to $680 were covered by the Medicare program. The government alleged that Dr. Campbell billed Medicare for several treatments that were either not performed or not necessary.
1 - Provide a paragraph with more than five sentences (i.e., in the section for “Purport”) that interprets the theme of the case, based on concepts learned
2 - What was the specific violation committed by Dr. Doyle E. Campbell?
3 - If Dr. Campbell were to be held legally liable, would his case be heard in what court and in what jurisdiction?
4 - Against who has the violation taken place?
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