The government routinely prosecutes medical care practitioners for
criminal law violations.
Criminal cases can result in imprisonment, large fines, and expensive
defense costs, which are not paid by medical malpractice insurance.
Criminal defendants have substantial constitutional protections.
Medical care practitioners must know the special criminal laws that apply
to medical care.
Medical care practitioners must know how to protect their rights in
Ten years ago, in the late 1980s, medical care practitioners were mostly
concerned with civil litigation, especially medical malpractice litigation. They
were constantly involved with administrative proceedings through
Medicare/Medicaid reimbursement and other federal pay programs, but this
was a billing office matter, not a source of personal constant concern for the
physicians and nurses. There were occasional criminal actions against
physicians who sold prescriptions for controlled substances and against
“Medicaid mills,” but “nice” physicians and hospitals did not worry about
criminal prosecution. Suggestions that physicians might face criminal
prosecution for what were considered routine business practices were
dismissed by most medical care attorneys. [Richards EP, Deters DJ, Gray RJ.
Physicians and their profession: do racketeering rules apply?
Nat Law J.
Now, prominent hospitals and medical schools have paid hundreds of millions of
dollars in administrative and criminal fines, health care practitioners and
administrators have gone to jail, and all hospitals are working on plans to
demonstrate compliance with federal law so that they can claim mitigation
under the Federal Sentencing Guidelines if they are accused of criminal
behavior. Although medical malpractice litigation continues at about the same
pace, it has faded into the background as a concern in the face of jail time or
the administrative law death penalty: banishment from all federal programs
and any facilities that deal with federal programs. It is critical that medical
care practitioners understand the special characteristics of the criminal law
system and how to protect themselves from liability.