For effective delivery of quality and standard healthcare services, legislations are imperative. The legislations ensure that medical professionals adhere to their expected professional ethics and principles when conducting medical business and offering healthcare services. Without proper legislations in the healthcare system, there would be unethical or poor healthcare practices that are not only detrimental to the lives of patients, but also to the entire members of the society. Since sustainability of the healthcare system depends on lucrative businesses that various healthcare institutions conduct, there is a tendency that these institutions can, at times, go beyond their prime mandate of offering quality and standard healthcare services, and focus on making profits. The tendency of health institutions to neglect their responsibilities and focus on fraudulent businesses that fleece patients and government could increase if proper legislations are not in place. Roath asserts that, “healthcare delivery has been increasingly recognized as a business avenue and hence regulatory norms are constantly becoming stringent” (2010, p.6). Government has realized that inefficient regulation and legislation of healthcare system would result into tragic consequences that cost lives of people due to unprofessionalism and negligence of ethics. In view of legal aspect of healthcare, this essay examines medical fraud by Robert Ray Courtney as a case study and explores criminal and contractual aspects of the case.
Case Background
Robert Ray Courtney was a pharmacist and a proud owner of a pharmacy called Research Medical Tower at Missouri, Kansas City since 1990. He began his pharmaceutical business in 1990 and embarked on illegal activities of buying fake drugs and diluting genuine ones to increase profit margins. The medical representatives who worked for him in the pharmaceutical company wondered that there was significant difference between amount of drugs they bought and the amount they sold. One of the suspicious medical representatives leaked the matter to an oncologist, Dr. Verda Hunter, one of the customers who usually bought cancer drugs. Dr. Verda Hunter too became suspicious and ordered nurses to carry out qualitative and quantitative tests on the cancer drugs bought from the Research Medical Tower Pharmacy, which proved that indeed there were dilutions of the drugs. Upon the discovery that Robert Ray Courtney had been adulterating cancer drugs, Dr. Verda Hunter notified healthcare authorities leading to Courtney’s arrest in 2001 pending more investigations.
According to investigations, Robert Ray Courtney has been diluting drugs since 1990 when he started his pharmaceutical company until 2001 when police arrested him for alleged drug adulteration. The preliminary report accused him of diluting over 90,000 prescriptions and over 70 different types of drugs, which had affected the lives of thousands of patients who used his medications. When the healthcare authorities arraigned him in court, Robert Ray Courtney “pleaded guilty to eight counts of product tampering causing serious bodily injury and twelve counts of adulterating or misbranding drugs…the district court sentenced him to thirty years in prison” (Hansen, 2005, p.). Due to the nature of his crime, the district court ruled that his imprisonment period would be 30 years, which was abnormally high because he did conduct medical fraud knowingly to satisfy his selfish interests for money. His case became a landmark that indicates how medical professionals can sacrifice human health for material gain.
Biographical Description
Robert Ray Courtney was born in 1952 in Kansas with a twin sister who is currently a preacher at the church of Assembly of God. He attended Wichita South high school in Kansas and went to University of Missouri where he earned a degree in pharmacy, which he achieved in 1975. After graduation in 1975, “Courtney went to work for pharmacist James Frederich, and soon was managing Research Medical Tower Pharmacy in Kansas City” (Roath, 2010, p.3). Working with James Frederich, Robert Ray Courtney gained enough experience on pharmaceutical practices and by 1990; he opened his own pharmaceutical company in Kansas City called, Research Medical Tower Pharmacy. In 2001, a suspicious medical representative reported him to one of the customers, Dr. Verda Hunter, who tested cancer drugs and found them diluted. Dr. Verda Hunter contacted the Federal Bureau of Investigation (FBI), and Food and Drug Administration (FDA) to conduct further investigation into the issue that eventually led to Courtney’s arrest.
Research Medical Tower Pharmacy had a humble start but it did exponentially rise leaving many people wondering about lucrative nature of pharmacy and entrepreneurship skills of Robert Ray Courtney. Robert Ray Courtney made great deal of money that increased his fame in Kansas City for he gave ‘good’ money for charity organizations, to his former school, and his church. His parents and friends praised him for being generous and encouraged him to continue for he was a role model since many envied and admired his character. In early 1990s, Research Medical Tower Pharmacy had began adulterating drugs to increase its profit margins because Courtney was able to divorce his wife and paid $200 000 as half of his property and in 1993, he remarried and acquired property worth $700 000. “In 1999, Courtney pledged $1 million to the building fund of the Northland Cathedral, where he worshipped. He made 2 payments of $333,000 in 1999 and 2000” (Roath, 2010, p.7). By the year 2001, Research Medical Tower Pharmacy had accumulated great wealth that resulted from its fraudulent activities.
Criminal and Contractual Aspects of the Case
The case of Robert Ray Courtney is a criminal activity that does not only violate medical professional ethics, but also encompasses fraud. He violated medical professional ethics of being an advocate of patient’s health concerns and helping them acquire appropriate and quality health care services. Instead, he defrauded them by attaching more importance to his selfish interests while neglecting his responsibility. According to Hansen, “the FBI estimates that the dilutions reverberated through 400 doctors, 4,200 patients, and up to 98,000 prescriptions … diluted and adulterated prescriptions surely led to incalculable suffering and consequences that reverberated through the lives of Courtney’s patients and their loved ones” (2005, p.8). Since the court found out that Robert Ray Courtney has been committing this crime for a period of ten years, it found it reasonable to imprison him for 30 years.
Due to the escalating cases of medical fraud in Kansas, the Congress has formulated legislations that allow for stiffer penalties including life imprisonment. The case of Robert Ray Courtney represented a worst-case scenario of medical fraud because it depicted the extent to which medical professionals can apply unethical professionalism if limiting legislations and penalties are not in place. The Congress has passed statute to ensure that, medical professionals who commit fraud face sentence of not more than ten years or pay fine or both. The statute provides stiffer sentences for medical fraud that results into injury or death, and as Bennett argues, “in the case of bodily injury, imprisonment of up to 20 years is allowed, while in the case of death, imprisonment for any term of years, or for life, is authorized” (2007, p.12). The district court of Missouri made a landmark ruling by exceeding the required sentence period that led Robert Ray Courtney to appeal for reduction after admitting his crime. The court of appeal reviewed the case of Robert Ray Courtney and ruled that they were reaffirming position of the district court, thus his appeal did not change the sentence.
In terms of contractual aspect, the case depicts the importance of proper federal legislations that will regulate activities of the healthcare system in case of any eventualities regarding fraudulence. In support of federal laws that check healthcare systems, the Congress has established the “Kansas Medicaid Control Act that prohibits knowingly making of a false claim, statement, or representation to the Medicaid program or its fiscal agent with the intent to defraud” (Bennett, 2007, p.14). This implies that concerted legislative efforts by the FDA, FBI, healthcare systems and the Congress is going to enhance contractual relationship in fight against medical fraudulence.
Conclusion
The case of Robert Ray Courtney presents a shocking revelation of what might be taking place behind the scenes of healthcare system. For more than ten years, Courtney managed to defraud unsuspecting patients and doctors alike by adulterating genuine drugs to get more profits. Although he was a competent pharmacist, he neglected professional ethics and concentrated on fraudulent business activity at the expense of many lives that suffered due to ineffectiveness of his drugs. Due to criminal nature of his fraud, the court found it reasonable to imprison him for 30 years and Congress continues passing stiffer amendments to curb increasing cases of medical fraud.
References
Bennett, M. (2007). Criminal Prosecutions for Medicare and Medicaid Fraud. Health Care Legislations, 1- 23.
Hansen, M. (2005). United States of America v. Robert Ray Courtney. The United States Court of Appeal, 1-17.
Roath, B. (2010). Robert Courtney. Journal of Medical Fraud, 6(4), 1-47.