I am not Sherlock H.
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I also agree with this. IANAL….. so not really able to determine, but at minimum medical malpractice is in order IMO. And depending on the circumstances, one might be able to find other greater harm etc. And maybe some other federal and/state regulations can also be utilized and applied.I also think it unlikely he’d be charged or prosecuted for murder. However, I could see the program with which he is associated suffering serious consequences from insurance providers whose clients were being essentially lied to. Those patients were not receiving the “standard of care” they and their insurance provider were led to believe they were and because this was artfully concealed from them, they did not seek out alternatives that would have provided that standard of care. And throughout the period of time those patients were “on the list, but not really,” their insurance providers were paying for services.
I would expect that providers might decline to support the program AND might seek reimbursement for services that were provided under fraudulent conditions.
I’d also expect that folks exist (the patients or their loved ones) who might have a case for fraud perpetuated against them that caused them harm and if there are many, there might be cause for a class action that challenges in such a way that the program is forced to expose the decision making behind their selection process as well as every case in which this manipulation of criteria resulted in exclusion from selection.
The harm perceived needs to be understood and reconciled. And as to intent, perhaps some aware of how patient privacy and medical privacy works may have used that to advantage? Or possible patient detriment IMO?
Fortunately (or unfortunately depending on how one slices this) HIPAA regulations will likely make it difficult for ‘outsiders’ to determine patients and their condition or needs. So it may not be easy to determine the ultimate wrongs, harms, ethical breaches, and / or possible criminal activity?
And for that reason, I hope some entity that can really dig in on this gets involved. I am hoping 60 Minutes takes it on.
It would be most unfortunate if a wall of silence or secrecy prevented this from being fully exposed - and prosecuted to the rightful fullest. MOO