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The consequences of committing health care fraud

On Behalf of | Feb 24, 2021 | healthcare fraud | 0 comments

When doctors or other health care professionals engage in fraudulent activity, their patients and other innocent victims suffer the repercussions. Because it is such a serious offense, professionals charged with health care fraud in Texas may face an onslaught of legal consequences.

When people know the potential consequences of unethical practices, they may have more incentive to avoid fraudulent behaviors.

Health care fraud defined

When medical professionals knowingly falsify information to collect reimbursements, this behavior qualifies as health care fraud. According to the Attorney General of Texas, dishonest behavior can cause patients higher out-of-pocket expenses and increase their health insurance premiums as well. Some examples of fraud include the following:

  • Negligently prescribing unneeded drugs and collecting the profits
  • Overbilling health insurance companies
  • Upcoding and pocketing the extra cash
  • Dishonestly declaring patients as Medicare or Medicaid members

Health care fraud effects

If found out, perpetrators of health care fraud will need to pay restitution to their victims. According to the Cornell Law School, Legal Information Institute, in serious cases, medical professionals could permanently lose their license to practice.

If convicted of fraud, health care professionals should understand the extent of their consequences so they can reduce collateral damage. Under certain conditions, medical professionals formerly stripped of their licenses may have the chance to have their privileges reinstated.  People petitioning to have their license reinstated will need proof of good behavior. They must have also successfully repaid restitution and observed all required regulations. While rebuilding a reputation will take time, it is possible for those who work relentlessly to correct their mistakes.


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