2 common examples of health care fraud 

On Behalf of | Mar 8, 2024 | Professional Misconduct |

Doctors, nurses and other medical professionals have to obtain licenses before they can practice. Ultimately, they are dealing with people’s well-being, so they are held to a very high standard. 

When a health care professional behaves inappropriately, or even criminally, their professional license can be revoked. An example of criminal activity in the medical field is healthcare fraud. Accusations of this type can place a professional license at risk. Here are some of the more common examples of health care fraud. 

1. Fraudulent billing 

Medical professionals and providers must ensure that they bill patients appropriately for consultations, tests, medications and procedures. There are several ways that a medical provider may attempt to earn more money than they should. Some common examples of fraudulent billing include: 

  • Phantom billing: This essentially amounts to billing for a service that the patient never received
  • Double billing: This involves purposely billing the patient twice
  • Unbundling: This is the practice of sending more than one bill for exactly the same service 
  • Upcoding: Upcoding means that the healthcare provider purposely bills a patient for a more expensive service rather than the one they actually received

Any type of fraudulent billing can result in both criminal charges and professional license revocation. 

2. Misuse of drugs 

Doctors and other medical professionals have access to a host of drugs. Used appropriately, these drugs can save lives. However, all drugs also have the potential to be abused. A doctor could face criminal charges and license revocation if they take drugs out of the facility for recreational purposes or to sell for personal profit. Handling and prescribing drugs is a huge responsibility, and misuse of drugs can result in criminal charges and professional licensing issues. 

If you are facing accusations of misconduct that threaten your professional license, it’s vital to seek legal guidance. This can help to protect your career and reputation.