I need assistance please to reply to this discussion post with references :

A NP in Florida was tried and found guilty of Medicare fraud in excess of more than 200 million dollars. She ordered excessive genetic tests for cancer screening and medical equipment that her clients didn't need or use. She signed thousands of orders for orthotic braces and genetic tests; more that some oncology offices combined state-wide. She worked in cahoots with a telemarketing company who would call Medicare beneficiaries and coerce them to ask their NP for these braces and tests. The company would send pre-filled forms to the NP and she would sign them. The devices and tests would never be used or conducted for the patients. She would also bill Medicare for office visits that never occurred, sometimes for 24 hours in a single day.

The jury without hesitation convicted her of health care fraud, wire fraud, and making false statements concerning health care matters. She was sentenced to 20 years behind bars. The ridiculous billing drew several red flags and the attention of Medicare who initiated an audit. It wasn't long before the evidence was gathered, and the verdict announced.

The Nurse Practitioner pocketed over 1.6 million dollars in total from her fraudulent scheme. She used the money to buy expensive jewelry, a new home, and luxurious cars. However, her lavish lifestyle was short lived, and she'll never practice medicine again. Luckily, no one was hurt in this investigation. The patients simply didn't receive the equipment and screenings they were promised.

My point of view: Obviously, insurance fraud is never worth the risk. I've heard a few stories from a couple of my nursing colleagues concerning this topic. They've personally worked with a few providers who were guilty of this criminal conduct. They simple left their jobs and worked elsewhere. They unfortunately did not report this misconduct to the proper authorities and regret not doing so. Moral of the story, we make great money as an NP, why risk it just to make more and potentially cause maleficence to your future patients?

Reference

Nurse practitioner convicted of $200M health care fraud scheme. (2023, September 21). https://www.justice.gov/opa/pr/nurse-practitioner-convicted-200m-health-care-fraud-schemeLinks to an external site.