If you are accused of being a “dirty doctor,” it means that the prosecutor believes that you intentionally deceived or misrepresented health care transactions for personal gain. Do not take these accusations lightly. Health care fraud is a serious crime that can risk your New York livelihood and your license to practice.
Forms of fraud
Health care fraud can take many forms. It can be billing for services not rendered, upcoding or unbundling of services, falsifying diagnoses or medical records, kickbacks or bribes, identity theft and prescription drug fraud. These health care frauds are on the rise and are said to be committed by “dirty doctors.”
So-called dirty doctors are physicians who authorities allege abuse their position of trust and authority to defraud insurance companies, Medicare, Medicaid or other health care programs. They may prescribe unnecessary or harmful drugs, perform unnecessary or harmful procedures, refer patients to fraudulent clinics or pharmacies or participate in schemes involving fake patients, fake injuries or fake accidents.
According to the FBI, health care fraud causes tens of billions of dollars in losses each year and can raise health insurance premiums, reduce benefits and coverage and compromise the quality and safety of health care. Health care fraud also harms patients who may receive substandard or dangerous care, suffer from addiction or overdose or have their personal information compromised.
New York doctors wrongly caught up in overzealous law enforcement efforts can lose years of work and their livelihoods.