Editorial: The criminalization of medicine

February 1, 2005

Last night you were on call and delivered three babies, managed a patient with severe preeclampsia, treated a case of uterine atony, and readmitted a woman with a post-hysterectomy wound infection. Yesterday you covered the hospital's Women's Health Clinic; it's a twice-monthly pro bono service you provide to the community. And this morning, you're facing a waiting room full of patients and two assistant U.S. attorneys. The grave-looking men in dark suits say they are investigating you for up-coding of Medicare and Medicaid claims and private insurance reimbursement. You're facing possible federal criminal prosecution, but you're not alone because the hospital also is being investigated.