Question: Consider the following scenario: You are the administrator of a suburban mental health clinic in need of psychiatrists. You hire a candidate who purports to be a psychiatrist. Over a one year period you notice that this individual generates many complaints related to poor care. There are several complaints made to the State Licensing Board regarding this individual's competence.
You engage a Nurse Risk Manager to review the case records of this individual. The Nurse Risk Manager concludes that this individual is not following current standard of care practice. Upon further review, it becomes evident that this individual has fraudulent credential and is not a physician/psychiatrist. Upon further review it is clear that your clinic has billed Medicare for services rendered by this fraudulent physician.
It is likely that if you share this information with your Board of Directors you will lose your job. What are the legal/ethical issues that you face and what should you do?