... to get money for patients -- or for themselves?
In an online forum otherwise respectable physicians report -- almost boastfully -- lying about patient diagnosis to obtain reimbursement from payers and try to justify their conduct by claiming corruption on the part of health insurance companies.
Keep in mind that we all pay premiums for that health insurance as well as Medicare, and even Medicaid and that insurance reimburses according to a voluntary contract between the payer and the beneficiary. Does such conduct constitute criminal fraud? violation of professional ethics?
I can recall similar conduct on the part of physicians as far back as the 1980s, but physicians complain about prior authorization, managed care and utilization review, and wonder how payers could mistrust them.
Roy Rogers used to say, "Two wrongs don't make a right."
Would you want your physician to lie about your diagnosis or other aspects of your history in order to obtain payment?