Ethics in health care: healthcare fraud

Gboyega A Ogunbanjo; Donna Knapp van Bogaert

Ethics in health care: healthcare fraud

Gboyega A Ogunbanjo University of Limpopo (Medunsa Campus)
Donna Knapp van Bogaert University of Limpopo (Medunsa Campus)

Keywords: healthcare fraud, white-collar crime, medical scheme, service providers

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.

Author Biographies

Gboyega A Ogunbanjo, University of Limpopo (Medunsa Campus)

FCFP(SA), MFamMed, FWACP(Fam Med), FCPCPZ Department of Family Medicine and Primary Health Care University of Limpopo (Medunsa Campus) Pretoria

Donna Knapp van Bogaert, University of Limpopo (Medunsa Campus)

PhD, DPhil Sessional Professor of Ethics Department of Family Medicine and Primary Health Care University of Limpopo (Medunsa Campus) Pretoria

Issue

Vol 56 No 1: January/February 2014

Section

Ethics CPD Supplement

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