551-7

Lesson 7

2. Kickbacks are criminalized when they induce federally funded care, that is, Medicare, Medicaid, and Tricare. In the Yellowstone Hospital kickback hypothetical, one behavior is criminalized because it entails payment of compensation that is above the market value for the landscaping job to one of the doctor’s sons. The doctor considers shifting his surgery patients to Yellowstone. Some of these surgeries are paid by Medicare, which is federally funded. Thus, this makes it a criminal activity. Because of the doctor’s son getting employment and payment that is above the market value, the doctor will make more surgeries and also shift the patients to Yellowstone. 

To some extent, the distinction makes sense. Dr. Cody maintains that HT was good enough to hire his son, who had failed to get a job elsewhere, and this makes him feel that he owes the hospital. Therefore, if Yellowstone gives a kickback by hiring his son, he will shift his surgeries from HT to Yellowstone. However, the first three actions do not directly affect federally funded programs. The first three actions are meant to make the aesthetics department appealing to the surgery patients just like or more than HT can. 

3. In this case, the victims of the crime include Yellowstone hospital, its management, and Dr. Cody. The Yellowstone hospital and its management hurt in that it violates the anti-kickback statute as it is the one that gave the kickback in favor of getting the surgery patients shifted from HT to Yellowstone. The two will be held liable for violating the statute. Dr. Cody is also hurt because he is the one who received the kickback in consideration of transferring the surgeries to Yellowstone from HT. He also violated the anti-kickback statute.