The criminal law focuses on allegations of illegal behavior, which allegedly may be carried out by health care providers. In this case, criminal responsibility requires representation and support to protect patients and providers. Underestimating the risks of patients and providers can help make better choices. It also ensures that the case is well documented and people know when to ask for help.

Types of complaints in healthcare

Criminal complaints in the healthcare sector can take many forms, depending on the factors or conditions that led to the complaint. For example, healthcare professionals may find themselves infringing on the privacy of protected health information involving patients. For patients who die within the first 24 hours, surgical negligence may also cause complaints. Healthcare organizations may also face complaints about possible health insurance fraud to the Department of Justice.

Medical insurance fraud, sometimes called bill fraud, is by far the most common crime in the healthcare field. A Medicare fraud complaint may be filed after a health care provider bills for services that are not provided, services that are not related to the patient's condition, or unnecessary procedures. Rebates for the use of certain products, repeated claims to third-party payers, and medical codes above the delivery value are also considered bill frauds.

Another popular health care crime is medical malpractice, which involves improper provision of health care. Criminal charges of medical malpractice include practicing without proper permission, establishing improper relationships with patients, treating patients without consent, and medical practices that harm patients or cause death due to medical negligence. Other common medical incidents include breaching the confidentiality of patient and health record discussions and overprescribing drugs such as steroids or anesthetics.

Criminal prosecutions may also be filed for potentially serious acts on behalf of health care providers. For example, the provider may be grossly negligent, performing illegal abortions, assisting patients in suicide, or possessing illegal drugs. Although state laws may differ on several issues, the criminal law in healthcare is largely the same.

Bottom line

Health is one of the most precious things in life and needs guidance at all times. However, certain conditions may cause harm to patients in medical institutions. Criminal law in healthcare is designed to protect individuals under the care of providers. It defines what constitutes a health care crime and the actions to be taken.