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Types of fraud that can threaten a medical license

On Behalf of | Dec 18, 2023 | Medical Licensing

Maintaining the integrity of the medical profession is paramount to ensuring public trust. Doctors must adhere to a wide array of ethical standards and legal regulations.

For this reason, engaging in fraudulent activities can lead to severe consequences, including losing one’s medical license.

Billing fraud

Fraudulent billing occurs when a doctor intentionally submits false claims to insurance companies or government healthcare programs. It can involve inflating the costs of medical procedures, submitting bills for unnecessary treatments or charging for services not provided.

Insurance fraud

This type of scam can take various forms, such as submitting false information to insurance companies and altering patient records to maximize reimbursements. Besides harming the insurance industry, these practices also lead to increased healthcare costs and reduced accessibility.

Patient identity theft

Doctors who steal the identity of patients are committing a grave offense. Examples of fraudulent acts stemming from this crime include falsely obtaining loans or acquiring credit cards in another person’s name. Medical identity theft is a growing worry. Respondents to an identity theft survey from U.S. News & World Report rate it as their fifth greatest fear.

Substandard patient care

While not a traditional form of fraud, providing inadequate medical care can also result in a medical license revocation. This may include negligence, incompetence or any form of willful misconduct that puts patients at risk.

Doctors swear an oath to maintain ethical conduct and uphold the confidence placed in them by the public. Healers must avoid committing fraud so that people do not hesitate to seek treatment when experiencing symptoms of illness.