Knowing about a crime and not reporting it is just about as bad as actually committing one. The official term for this act is misprision, or the failure to report a known felony to authorities even though the person reporting the offense is not directly involved. In today’s “Fraud of the Day,” an article posted on WKRG.com details the story of a doctor who knew about billing fraud occurring at his skin care clinic, but did nothing to report the illegal act. (Just knowing about a crime unfortunately means you are involved.)
The story states that a nurse practitioner, who worked at a Mobile-area skin care clinic, had a bad habit of creating false billing records for patients who sought treatment at the facility. She allegedly fabricated statements that showed patients had received certain treatments, when in reality they had not received any services at all. The fake bills were then submitted to an Alabama insurance company as well as to Medicare and Medicaid for payment.
Apparently, the well-known doctor was aware of the billing fraud taking place in his office. (If only he could have confessed or even stopped the unlawful practice, prospects of a jail-free future would have been better.)
The doctor pleaded guilty to allegations that he knew about the fraud and admitted he concealed the offense to avoid an investigation. (Avoiding a difficult situation in the beginning can mean a higher price is paid in the end.) He faces three years in prison and a $250,000 fine. The nurse’s court date has been scheduled.
It is hard to tell what kind of impact this doctor’s actions will have on his practice. By concealing the nurse practitioner’s alleged crime from the authorities, his actions may cause his patients to think twice about seeking treatment from his clinic. Hopefully, the doctor has learned a valuable lesson in that it only takes one lie, or an act of misprision, for people to lose faith in you.