March 17, 2016

When Does Inadequate Medical Care Cross The Line Into Fraud?

By the C|C Whistleblower Lawyer Team

The New York Times recently ran a story about eating disorder clinics—plush retreat centers that purport to cure the notoriously hard-to-treat and potentially deadly health conditions anorexia and bulimia.  These centers are often owned by investors, and aggressively market themselves to increase revenues, including by advertising their luxury accommodations and encouraging referrals from outside providers through fancy trips and gifts.  Yet the centers rarely provide treatment by licensed health care providers using scientifically verified treatment courses.  As summarized by the director of the eating disorders program at the Johns Hopkins Hospital, Dr. Angela Guarda:  “For the most part, the people who are running and working in these programs believe they’re doing the right thing, … [b]ut it’s a slippery slope[.]….“Money can cloud your view.”

The Times’s story leaves open the question of whether these ineffective and expensive treatment facilities rise to the level of fraud.  Just because one treatment option is both less effective and more expensive than another does not necessarily imply bad intent on the part of the providers.  Financial motivations are, after all, part and parcel of the U.S. medical system.  On the other hand, providing unverified treatments with a foremost eye to profit raises the specter that marketing, not treatment, is the centers’ primary goal.

Do You Think Eating Disorder Centers Are Fraudulent Entities?

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