Medicare Compliance & Reimbursement

Think the federal government isn’t still taking health care fraud and abuse seriously? Think again.

In a case that demonstrates just how odious government enforcement agencies — and the nation’s courts — consider health care fraud, the U.S. Supreme Court is poised to lay down the law on whether a mentally ill health care provider can be forced to take anti-psychotic drugs to stand trial for his alleged crimes.

The case is an appeal from an 8th U.S. Circuit Court of Appeals decision holding that the government did indeed have a right to compel Dr. Charles Sell to take anti-psychotic medication. Sell was accused of health care fraud, money laundering and other charges and had long struggled with mental illness.

The feds maintained that the meds, which Sell didn’t want to take, were the only thing that would render him competent to stand trial. Sell had been diagnosed with delusional disorder, persecutory type.

Forcible medication is a serious matter usually reserved for the worst of crimes, but in ruling for the government last year the 8th Circuit maintained that health care fraud is such a menace that the feds were justified in forcibly medicating accused perpetrators.

The Supreme Court heard oral arguments in the case, Sell v. United States (No. 02-5664) March 3, though whether it will rule on the merits is an open question since the justices appear concerned with certain technicalities of the appeals, and asked the parties to brief those issues separately.

Lesson Learned: Make no mistake about it, the government still considers health care fraud to be serious business.