Working as a nurse often involves dealing with extremely stressful professional situations. With so much to keep track of and patients’ well-being at stake, a nurse can make a mistake or forget to do something important. Although these mishaps must be taken seriously, they usually don’t provide grounds for severe punishment or loss of employment.
However, if a nurse crosses the line between innocent error and fraudulent behavior, they can face severe penalties and repercussions including suspension, criminal charges, and loss of their nursing license. If you are accused of fraud in a nursing situation don’t wait to take action to protect your rights, your nursing license, and your future career. Reach out to an experienced nursing license defense lawyer immediately.
How Might You Be Accused of Fraud as a Nurse?
Due to the nature of the profession, there are many situations where a nurse can be accused of fraudulent behavior. Some of the most common fraud accusations in nursing arise from situations where the nurse:
- Claims they performed a home health visit, but they did not go to the patient’s home
- Says they looked in on a patient in a healthcare facility, but never entered the patient’s room
- Indicates on the patient’s chart that medication was given at a certain time, but the nurse did not administer the medication
- Lies on a nursing license application or nursing license renewal form
- Changes the patient’s chart to show services provided that were never given
- Modifies the chart to change certain times, for example, showing a drug was given two hours before it was actually done
Creates fake billing such as:
- Falsely charging for services or items never provided
- Over-billing for different stages of a procedure as if they were separate procedures
- Billing for a more expensive procedure than the one the patient received
- Falsifies a signature or record to cover fraudulent billing
- Steals from an employer or a patient
- Fails to report a patient care error
- Changes insurance codes to over-bill the insurance company
- Bills Medicaid or Medicare for services not performed
- Creates a fake patient, often at a doctor’s request, to submit bills and pocket the payments
- Fraud in a job application, such as not disclosing that you were fired from a previous job
Nurses who provide in-home care are often most susceptible to fraud accusations since they are working outside a facility without immediate supervision.
How Can Nursing Fraud Be Discovered?
If a healthcare facility suspects nursing fraud, the administrators may take several steps to investigate the situation. For example, they may track the nurse’s cellular GPS to show the nurse was at home when they reported being at a patient’s location. Or if a home-bound patient reports not seeing the nurse for a long period of time, they can review Medicare or Medicaid claims submitted during those times.
In a hospital situation, administrators can review facility hall cameras to see whether the nurse entered a patient’s room when they claim they were there. For example, if the patient’s chart indicates they received medication at a certain time, but hallway video evidence shows the nurse did not enter the room, the nurse could be charged with fraud for falsifying the chart information.
Possible Employment Repercussions if You’ve Been Accused of Fraud as a Nurse
Being accused of fraud as a nurse is a very serious situation. You may face state and/or federal agencies that handle fraud accusations depending on the circumstances. Administrative agencies such as the Board of Nursing can impose penalties ranging from reprimands and censures to full revocation of your license to practice.
If you are accused of healthcare fraud, your nursing job may be on the line. All medical employers must investigate potential fraud and report their findings to the appropriate authorities. If you are facing a nursing fraud investigation your employer may suspend you from all duties or place you on administrative leave.
A healthcare fraud conviction can have additional long-term repercussions as well such as being on a list that will not allow you to work in a facility that accepts Medicare and Medicaid.
If convicted of fraud, a nurse may face long-term impacts including:
- Difficulty rebuilding trust with an employer and growth in their nursing practice
- Being ineligible for raises, more work responsibilities, or promotions
- The inability to find new nursing employment after being fired
For many nurses, a healthcare fraud conviction means the end of their nursing career, at least for a while.
How Can Nursing Fraud Accusations Affect Your Nursing License?
The Board of Nursing will likely review your nursing license in light of fraud accusations. Each state has a Board of Nursing that investigates, holds administrative hearings, and follows other procedures to ensure all nurses are capable of performing their duties.
When fraud is alleged, a Nursing Board may take action against a nurse in a related but separate process. The Board will pursue an internal investigation and may hold an administrative hearing to determine if a nurse committed health care fraud. If a nurse is found guilty of dishonesty or fraud, they can face several penalties ranging from a reprimand letter to suspension or even license revocation.
If you are contacted by someone related to an accusation of nursing fraud, do not speak to them without the protection of a lawyer who is experienced in this area of law. Never give a statement to an investigator, police, or anyone from the Board without an attorney present. Many nurses think they did not do anything wrong, so it won’t hurt to discuss the matter. That is a huge mistake.
Why You Need a Nursing License Defense Lawyer to Defend Fraud Accusations
If you were charged with criminal fraud, you need to work with a criminal defense attorney to ensure your rights are protected and the outcome of your criminal case is fair. However, most criminal defense lawyers know nothing about protecting a nursing license and cannot offer help when you are dealing with your state Board of Nursing.
In a nursing fraud situation, you should work with a lawyer whose practice is dedicated to defending nursing licenses in addition to your criminal defense team. The legal and administrative processes you must face are complicated, and the possible outcomes are incredibly important to your career and overall future. As a licensed registered nurse and attorney, Lorie Brown understands the gravity of your situation, and she has the skills and experience to guide you through a fraud accusation.
Contact Lorie Brown if Your Nursing License is Threatened by Allegations of Healthcare Fraud
Every nursing fraud case is unique and must be considered on its facts and circumstances. At first, you may be dealing with government prosecutors or federal agencies, but eventually, administrative agencies such as the Board of Nursing will become involved. Administratively, your license may be revoked or suspended depending on the severity of the fraud charges alleged against you.
When facing the Board of Nursing, you need a high-quality defense to minimize the repercussions you may face from the administrative board. The best time to start defending your license to practice nursing is before you face an investigation or administrative hearing. When you partner with Lorie Brown, she can help investigate your situation and begin preparing your defense immediately.
As soon as you suspect you may be accused of nursing fraud, reach out to a dedicated nursing defense lawyer to help protect your license, your career, and your future. Contact Lorie by calling (317) 465-1065 or fill out this online contact form to tell us your story and begin protecting your rights.
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