I am not proud of my track record.

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l1234567

67 Posts

Yes but she may be able to get credit towards another program. But I'm not from the US. If she gets a good lawyer and revokes her license she may not get what I'm assuming is referred onto criminal charges. I would recommend her self revoking her license it may go a long way with the board at least from what I've gathered from our equivalent of BON. She may still be required to front them but it may not be so bad

eta: I'm sure there's an actual process that school has to undertake before they kick her out

OrganizedChaos, LVN

1 Article; 6,883 Posts

Specializes in M/S, LTC, Corrections, PDN & drug rehab. Has 10 years experience.
Yes but she may be able to get credit towards another program. But I'm not from the US. If she gets a good lawyer and revokes her license she may not get what I'm assuming is referred onto criminal charges. I would recommend her self revoking her license it may go a long way with the board at least from what I've gathered from our equivalent of BON. She may still be required to front them but it may not be so bad

eta: I'm sure there's an actual process that school has to undertake before they kick her out

Getting charged criminally vs. losing her license are two different things here. The BON might take away her license but the CMS might prosecute her.

l1234567

67 Posts

Anyway good luck OP.

allnurses Guide

Nurse SMS, MSN, RN

2 Articles; 6,840 Posts

Specializes in Critical Care; Cardiac; Professional Development. Has 12 years experience.
Yes but she may be able to get credit towards another program. But I'm not from the US. If she gets a good lawyer and revokes her license she may not get what I'm assuming is referred onto criminal charges. I would recommend her self revoking her license it may go a long way with the board at least from what I've gathered from our equivalent of BON. She may still be required to front them but it may not be so bad

eta: I'm sure there's an actual process that school has to undertake before they kick her out

There is no process when it comes to action taken by the BON to revoke one's nursing license. If you are under investigation by the BON, the school is going to assume you will be a blight on their good reputation and likely suspend until determination is made on BON action against the individual. It is also pretty common in the US that once you get removed from a nursing school for this type of situation it is next to impossible to get readmitted anywhere else.

l1234567

67 Posts

I'm not sure how voluntarily surrending your license and studying something completely different doesn't seem like fair advice. Also the OP has not said the school has been notified etc. so I think it is fair advice to not disclose it to the school. I get Being kicked out of studying or having a suspension would be negative for doing different study. I'm essentially recommending not be a nurse but use her education to hopefully do something else. Perhaps she could do a transfer into a different course if her Uni allows it. There doesn't seem to be a national BON in the US but I've spent a little while looking at the sites and voluntarily handing in your license seems like a good idea. Nor had the OP stated that CMS contacted her.

OrganizedChaos, LVN

1 Article; 6,883 Posts

Specializes in M/S, LTC, Corrections, PDN & drug rehab. Has 10 years experience.
I'm not sure how voluntarily surrending your license and studying something completely different doesn't seem like fair advice. Also the OP has not said the school has been notified etc. so I think it is fair advice to not disclose it to the school. I get Being kicked out of studying or having a suspension would be negative for doing different study. I'm essentially recommending not be a nurse but use her education to hopefully do something else. Perhaps she could do a transfer into a different course if her Uni allows it. There doesn't seem to be a national BON in the US but I've spent a little while looking at the sites and voluntarily handing in your license seems like a good idea. Nor had the OP stated that CMS contacted her.

Nothing is overnight. It took this long for the BON to contact her. Maybe the CMS hasn't been notified yet or they are processing everything.

As far as her punishment goes, it depends on how the members of the BON feel. Yes it's her first time but she has repeated the same error over & over. I saw one person's license was suspended due to respondent engaging in conduct likely to deceive, defraud or harm the public. The OP did just that.

I wouldn't get the OP's hopes up that she might just get a slap on the wrist. Especially if the BON reports to other agencies.

allnurses Guide

Nurse SMS, MSN, RN

2 Articles; 6,840 Posts

Specializes in Critical Care; Cardiac; Professional Development. Has 12 years experience.

If the OP lives in DFW/Texas, she also will be reported to Group One, making her virtually unemployable in Texas.

I think voluntarily handing in her license is the prudent thing to do...but prudence and ethics are not her strong suit. Should she be able to apply whatever courses she can to another, nonmedical degree? Sure.

Specializes in pediatrics; PICU; NICU. Has 45 years experience.
If the OP lives in DFW/Texas, she also will be reported to Group One, making her virtually unemployable in Texas.

I think voluntarily handing in her license is the prudent thing to do...but prudence and ethics are not her strong suit. Should she be able to apply whatever courses she can to another, nonmedical degree? Sure.

I'm just curious; what is Group One?

caliotter3

38,333 Posts

I'm just curious; what is Group One?

Put "Group One" into the search box at the top of the page and you will come up with many references to it on the site. Essentially it is an entity that has amazing powers to keep a person from working in many healthcare facilities where it is utilized.

lrslinger

4 Posts

I do think you have some serious problems and are in need of professional help. I know many responses have suggested either directly, or indirectly, that you should peruse another profession. However, for all of the reasons others have articulated, at this time in you life I think you are unlikely to succeed at any profession. I do think that with the right help you can develop the ethical framework that will allow you to move ahead but you need to choose to do that.

Libby1987

3,726 Posts

This information was readily available at my fingertips:

[QUOTE]

It's estimated that as much as 10 percent of all the money spent on health care every year is paid out on fraudulent claims. Health care fraud is a crime in which someone uses lies, deceptions, or falsehoods when filing a health care claim in an effort to make a profit or to gain some type of benefit. There is no single type of health care fraud, and health care providers, patients, and even health insurers can commit this crime. Health care fraud is a crime addressed by both state and federal laws, and one that has significant potential penalties.

Fraud vs. Mistake

It's important to distinguish health care fraud from mere mistakes, omissions, or improper payments. To commit fraud, a person must knowingly engage in a plan, scheme, or activity to provide falsehoods, with the intent to achieve some financial gain. Fraud is not the same as, for example, making a mistake that results in a patient being billed for treatment he or she did not receive. By contrast, when a health care provider knowingly provides treatments or procedures that the provider knows patients do not need, and then bills an insurer for those procedures in order to make a profit, such conduct is health care fraud.

Fraud Schemes

Although anyone involved in the health care process can commit health care fraud, it is most commonly committed by providers in an attempt to obtain more money from insurers. Common fraud schemes involve double-billing or filing duplicate claims for the same service, filing claims for services never provided, billing for services not covered by an insurer's policy, and even providing kickbacks for referrals.

Common fraud schemes perpetrated by patients include faking a medical condition in order to receive medications that the patient then sells, falsifying medical claim information, or using someone else's insurance information to receive health care services.

State and Federal Laws

State laws on healthcare fraud differ considerably. State healthcare fraud laws typically fall into one of three types; false claims laws, self-referral laws, and anti-kickback laws. Some states have laws that address all three types of activity, while others may have only one or two, and some may have none at all.

In addition to any state prohibitions against health care fraud, federal health fraud law will apply in most situations. This law is very broad, applying when anyone makes an attempt to defraud any health care benefits program with the intent to gain control of money or property. The federal law applies in all states regardless of whether state law punishes health care fraud as a crime.

(18 U.S.C. section1347)

Medicare and Medicaid Fraud

The health care system has both private and public health insurers, and healthcare fraud can involve either of them.The two public health care insurers, Medicaid and Medicare, have long been targets of fraudulent claims, and there are a number of federal laws which apply to such situations. Specific federal laws criminalize making false claims in a Medicaid or Medicareclaim (18U.S.C. section 287), making false statements (18U.S.C. section 1001), as well as related activity.

Penalties

Federal law provides for both civil and criminal penalties for health care fraud. The difference between a civil penalty and a criminal one is that criminal penalties allow for fines, prison, and an order to pay restitution (compensate the victim for any money lost as a result of the fraud). Civil penalties only result in an order to pay restitution (no jail time or fine). Criminal health care fraud charges, both at the state and federal level, can lead to serious consequences for anyone convicted.

  • Prison.Health care fraud is a serious offense, and can lead to lengthy prison sentences. Making a false claim or false statement in relation to a Medicaid or Medicare claim can result in a 5 year prison sentence per offense, while a conviction for federal health care fraud can result in a 10 year sentence for each offense. If the health care fraud results in serious bodily injury to someone there is a potential sentence of up to 20 years in prison, while an act of health care fraud that results in someone's death has a potential life sentence.
  • Fines.Anyone convicted of health care fraud also faces significant fines. For example, an individual making a false statement in a Medicaid or Medicare claim faces a fine of up to $250,000 per offense, while organizations which make false claims face up to $500,000 per offense. Organizations that engage in ongoing schemes which involve multiple counts of health care fraud violations can face millions, or even billions of dollars in fines.
  • Restitution. As part of a criminal fraud sentence, the judge can order defendants to pay back the amount of money they improperly obtained as a result of their fraudulent acts. For example, a doctor who improperly billed an insurance company for tests not performed, and who received payment for these tests, can be ordered to pay this money back to the insurance company. Restitution is in addition to a fine, which is paid to the government.

  • Probation.An individual convicted of a health care fraud crime can also face a potential probation sentence. Probation limits the freedoms a person has instead of sending the person to serve their sentence in prison. Probation usually lasts as least 12 months, though sentences of three years or more are possible. Those on probation must comply with specific conditions, such as regularly meeting with a probation officer, maintaining employment, not associating with known felons, and not committing more crimes.

Speak to an Attorney

Health care fraud can seem like a minor crime, especially when an individual commits an act that seems like it has little impact and doesn't really "hurt anyone." But a conviction for health care fraud, especially when the defendant is a professional who depends on a license to practice, can irreparably change the course of that professional's life. Even being investigated for health care fraud can ruin one's professional reputation and make life incredibly difficult.

The moment you are approached by investigators about a potential fraud case, you need to contact a criminal defense attorney. You can unknowingly incriminate yourself anytime you speak to an investigator if you don't have legal advice. Local criminal defense attorneys are the only people capable of providing you with legal advice in light of their knowledge of the law, as well as their experience with local prosecutors, courts, and criminal investigations.

If you're being investigated for breaking a federal law, your case will be handled in the federal court system. Be sure that the lawyer you choose has experience handling federal cases.

source: http://www.criminaldefenselawyer.com/crime-penalties/federal/Healthcare-Fraud.htm

In summation: you may be investigated for Medicare fraud in the near future-so not only the possibility of not having a license is in the future, it may be your freedom, as well.

Medicare fraud is such an egregious act that even the BON can forward this information, if your employer hasn't done so.

And we have these fraudulent folks to thank more anyone or anything else for the tremendous amount of documentation and hoops to jump through.