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September 20, 2000

Should Physicians Manipulate Reimbursement Rules to Benefit Patients?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(11):1382-1383. doi:10.1001/jama.284.11.1378

To the Editor: The study by Dr Wynia and colleagues1 regarding physicians manipulating reimbursement rules points to the inherent ethical tensions between providing medical care that will benefit patients and providing care that is covered by insurers. The American Medical Association's Code of Medical Ethics is explicit regarding physicians' obligation to be truthful and to abstain from any fraud or deception. Opinion 9.132 of the Code states that "Physicians should make no intentional misrepresentations to increase the level of payment they receive or to secure non-covered health benefits for their patients."2 Physicians must follow ethical and legal standards when advocating for their patients.

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