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July 25, 2008

If a patient receives insurance checks directly, cashes them, and refuses to pay the physician, aside from sending that patient to collection, might criminal charges also apply, and on what grounds?

Q:

If a patient receives insurance checks directly, cashes them, and refuses to pay the physician, aside from sending that patient to collection, might criminal charges also apply, and on what grounds?

A: Arguably, if a patient cashes a check meant for a physician and then refuses to pay the physician, this could be considered theft of services.   However, it is very unlikely that a prosecutor will take this sort of case since most prosecutors generally consider these cases no more than simple private collection cases.  While some states allow individuals to prosecute criminal cases, many, including most of the larger counties in New York state, do not. 

The author is a health law attorney with Kern Augustine Conroy & Schoppman in Bridgewater, NJ, Lake Success, NY, and Philadelphia. He can be reached by e-mail atkern@drlaw.com.

The answers to these queries are general opinions and are not intended as substitutes for legal advice. You should not rely on these replies in making decisions involving questions of law, but should instead consult with competent legal counsel.