Legal/Professional Issues for Advanced Practice Nurses Ask The Expert
Is It Considered Insurance Fraud for a Clinician to Try to Save a Patient Money on Pr
from Medscape Nurses
Is it insurance fraud to save a patient money on prescriptions by treating, for example, "androgenic alopecia" with a prescription for finasteride (Proscar) -- a treatment for benign prostatic hypertrophy -- instead of the more expensive finasteride (Propecia) used to treat male pattern hair loss?
from Carolyn Buppert, CRNP, JD, 06/19/2003
Yes, it is fraud, unless the patient has benign prostatic hypertrophy (BPH) and is balding. Fraud is defined as: "an intentional deception or misrepresentation which the individual knows to be false or does not believe to be true, and the individual is aware that the deception could result in some unauthorized benefit to him/herself or some other person."
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