Legal nurse consultants may detect tampering with medical records. What happens to healthcare providers who get caught? What are the altering medical records consequences?
Shame and embarrassment
Loss of reputation, shame, guilt, and being exposed as a wrong doer can all have a profound impact on the individual who altered medical records. It is terribly awkward and difficult to be caught. But it gets worse.
In many states, falsification of medical records is also a criminal offense punishable by fines and incarceration.
Altering medical records consequences also include insurance coverage
A medical malpractice claim that includes an allegation of alteration of records may not be covered by a commercial professional or individual’s liability policy. The insurer may reserve its rights to not pay any judgment that might be entered against the provider.
Institutional providers participating in self-insured trusts may have similar coverage limitations. Some states recognize a separate cause of action for alteration of medical records, whereas other states deal with it as a jury charge.
If the provider admits that he or she has made the alteration, the policy may be completely voided.
An individual who has his or her own insurance policy may find the carrier refusing to renew the policy the following year.
Regulatory agencies and privileges
Some state regulatory or licensing boards may investigate the healthcare provider. Disciplinary action may follow. The healthcare system that has provided privileges to the healthcare provider may be reluctant to allow that individual to continue on the staff. Those who falsify medical records risk more than just the loss of a malpractice case.
Medical boards have suspended or revoked the licenses of healthcare professionals caught tampering with records.
A physician gets a notice that he is being sued. He gives into the temptation to review his office records. He decides to change an entry to
1. More completely describe events
2. Make it look as if he did something that he did not.
But it is way too late. The plaintiff attorney and her legal nurse consultant already have the record and spot the change when they receive a second set of medical records. A charge of spoliation of evidence is added to the suit.
Most healthcare providers who tamper with medical records have a mistaken belief that their actions cannot be detected. The guilt or fear of being found negligent swamps their good judgment. Altering medical records consequences take over.
Pat Iyer MSN RN LNCC is president of The Pat Iyer Group. Pat shared what she knows about altered medical records when she presented a webinar on the topic. Get details on how you can benefit from this knowledge.