Ethics in health care: Healthcare fraud

Abstract

Healthcare fraud is a type of white-collar crime involving the filing of dishonest healthcare claims in order to achieve a profit. Healthcare fraud is a worldwide problem and is on the increase in South Africa. In this article, healthcare fraud is explored, healthcare fraud identified as a white-collar crime and the South African legal term, “fraud”, defined. Common types of medical aid fraud, a rising concern within South African healthcare practice, are detailed. Finally, the role of ethical and moral reasoning is deliberated and the psychological factors that are believed to contribute to fraud discussed. Healthcare fraud is not a victimless crime. Therefore, healthcare professionals must inform on colleagues who practice it.