Fraud In Medicine
To report physician fraud call 1-800-663-6114
The Board for Professional Medical Conduct
The New York State Board for Professional Medical Conduct consists of physicians and non-physician public members. The New York State Legislature created the Board within the New York State Department of Health to handle problems regarding professional conduct among medical professionals (medical professionals include: physicians, medical residents, physician assistants, and specialist assistants).
Conduct intended to deceive.
What You Can Do About Fraud
- First and foremost REPORT IT!
- Any person can and should report fraudulent behavior. Physicians, hospital administrators and health maintenance organizations, in particular, have a legal obligation under public health law to report fraudulent practice.
What Will Happen to Your Report
- After you file a complaint, the Department of Health will investigate and, if it suspects fraud, present the matter to the Board.
- The Board will carefully review your complaint, and if it appears to describe fraudulent practice, charges will be filed and a hearing will be scheduled. The hearing will be conducted before a panel of two physicians and one public member.
- If the medical professional is found guilty of fraud, penalties may be imposed, such as unpaid community service, fines, suspensions or license revocations.
- Successful prosecution of fraud will be publicized in a widely distributed written report and on the Internet. The name of the person filing the complaint will be held in confidence, as required under law. Legal action cannot be upheld against a person filing a complaint in good faith.
Examples of Medical Fraud
- False and intentionally misleading statements to patients.
- Submitting false bills or claims for service.
- Falsifying medical records or reports.
- Lying about credentials or qualifications.
- Unnecessary medical treatment or drug prescription.
Important Patient Behavior
- Patients are often upset by the high cost of medical care and occasionally will dispute a fee charged for services.
- Patients who have a complaint about a fee may contact their county medical society. The Board does not handle fee disputes.
- It is unethical for a patient to request a physician to bill dishonestly or to provide a fraudulent report. It is misconduct for a physician to commit these acts.
How to Reach Us
- New York State Department of Health
Office of Professional Medical Conduct
150 Broadway Suite 355
Albany, New York 12204-2719
- 1-800-663-6114 - Complaints/Inquiries
- 1-518-402-0836 - Main Number
- Web Site Address: www.nyhealth.gov/professionals/doctors/conduct/
- E-Mail Address: firstname.lastname@example.org
You can help prevent fraud in medicine.
To Report Physician Fraud Call 1-800-663-6114