Criminal Law / Civil Law - Essay Example

In the case against Dr. Robert W. Stokes, the federal government of the United States filed the suit. Dr. Stokes (defendant) had a case in which the government (United States of America) was the plaintiff. As such, Dr. Stokes’s case is a criminal case and is dealt with under criminal law. After a jury trial in which Boggs More and Gibson were the circuit judges, Dr. Robert W. Stokes was charged with thirty –one counts of frauds in health care. Actual Charges Filed Against Him Dr. Robert W.

Stokes, a licensed and board-certified dermatologist who was operating in Grand Rapids, Michigan, was charged with thirty –one counts of frauds in health care. The federal agents initiated investigative audit Stokes billing practices in 2001into to determine if he was billing Medicare and insurers higher than the actual cost of services that he rendered to outpatients. The Fed agents established that Dr. Stokes had significant improprieties in his billing practices. According to the audit report, Dr.

Stokes wrongly informed his patients that they had cancer and performed unnecessary procedures so as to receive higher reimbursement. Further, Stokes used falsified billing systems, such as up-coding surgical procedures in order to receive higher rates of compensation. Dr. Stokes was also found to have frequently billed office visit and a surgical procedure in a single day, which was prohibited by insurers. Dr. Stokes diagnosed his patients with impetigo, a rare condition in adults, to justify the unnecessary office visits.

It was found that he failed to properly sterilize medical equipments he was sharing on patients. Dr. Stoke was thus charged with numerous counts of health-care fraud. Health care professionals are expected to act morally and ethically in their practice (Clevette, Erbin-Roesemann & Kelly, 2007). In his defense, Stokes emphasized good faith and argued that the mistakes were honest mistakes, but this was rejected by the court on the ground that the evidence showed knowledge and intent by him in his actions.

In a similar case, Professor Thomas Butler was convicted for defrauding the Texas Tech University for unnecessary consulting for drug companies (Enserink, 2005). According to Nolan and White (n.d), a person is liable under the federal False Claim Act when the person intentionally presents a fraudulent claim for payment or utilizes a false record to defraud or conspires with others in a violation of the False Claim Act. Health care frauds such as coding false claim, as in Dr. Stokes case, constitute False Claims Act (Nolan & White, n.d). The Punishment He Received and the Justification of the Final Outcome Upon establishing that Dr.

Stokes was guilty of the thirty-one counts of health-care fraud based on the evidence presented before the court, the district court then proceeded to determine Stokes’s sentence. The sentence was calculated with relevant advisory guidelines range. The court counted the patients of Dr. Stokes’s among his victims and applied a six-level enhancement for a violation with 250 victims or more, under the provisions of USSG §2B1.1 (b) (c). Arguing that the six-level enhancement was uneven with mischief suffered by the patients, the court departed it to two levels, which it found to fit Stokes’