PRESCRIPTION FORGERY CRIME

Entrance

Healthcare encompasses all services provided to improve individuals' quality of life and combat disease. Prescriptions, a crucial component of these services, are fundamental tools doctors use to determine and guide patients towards appropriate treatment. However, in recent years, prescription forgery has become a problem threatening the reliability of healthcare services and has also become a significant topic of debate in health law.

Prescription forgery is a situation that endangers both patients' health and public health. This article will examine the issue of prescription forgery within the framework of the Turkish Penal Code and other relevant legislation, providing a legal assessment. Furthermore, judicial decisions and practical problems encountered in relation to this crime will be investigated.

I. Prescription Forgery

I. The Concept of Prescription Forgery

Prescription forgery refers to the illicit acquisition of medications through forged prescriptions issued by doctors, pharmacists, or patients. A forged prescription may involve imitating a doctor's signature or stamp, or it may be created by altering an existing prescription. This situation endangers the patient's health and leads to the misuse of medications.

Prescription forgery is generally carried out for financial gain and is a common occurrence, especially in the illegal procurement of prescription and expensive medications. Forged prescriptions can also be used to obtain narcotics or stimulants.

II. Prescription Forgery in the Turkish Penal Code

Although prescription forgery is not a directly regulated crime in the Turkish Penal Code (TCK), this act can be considered within the scope of forgery crimes and violations of health legislation. In this context, various articles of the TCK contain legal sanctions related to prescription forgery.

• Turkish Penal Code Article 204 – Forgery of Official Documents: Prescriptions are considered official documents issued by doctors, and issuing a forged prescription or altering an existing prescription may constitute the crime of forgery of official documents under this article. According to the article: "A person who forges an official document, uses a document that is contrary to the truth, or commits forgery in such a document shall be punished with imprisonment from two to five years."

Since prescriptions are considered official documents, prescription forgery falls within this scope. Specifically, forged prescriptions issued without the doctor's knowledge, or the imitation of a doctor's stamp and signature, constitute this crime.

• Turkish Penal Code Article 207 – Forgery of a Private Document: If a prescription is not issued by a public official, but is a document issued by a private healthcare institution, then the crime of forgery of a private document arises. Article 207 of the Turkish Penal Code defines this crime as follows: “A person who forges a private document or uses a document that is contrary to the truth shall be punished with imprisonment from one to three years.”
• Turkish Penal Code Article 158 – Aggravated Fraud: Prescription forgery can also be considered a crime of fraud. Specifically, obtaining unjust enrichment by procuring medication through social security institutions constitutes aggravated fraud under Article 158 of the Turkish Penal Code. Because this crime involves unjustly benefiting from healthcare services and causing harm to the public, the penalties are more severe. Article 158 of the Turkish Penal Code is regulated as follows: “If the crime of fraud is committed to the detriment of public institutions and organizations, a prison sentence of three to ten years and a judicial fine of up to five thousand days shall be imposed.”

II. Relevant Legislation in Combating Prescription Fraud

I. Law No. 6197 on Pharmacists and Pharmacies

Law No. 6197, which contains regulations concerning pharmacists and pharmacies, is one of the important legal tools in the fight against prescription forgery. This law defines the rules that pharmacies must follow in the prescription and drug supply processes and regulates the sanctions to be applied in case of violations of these rules.

For example, professional disciplinary sanctions are stipulated for pharmacists who supply medication with forged prescriptions or accept such prescriptions. Furthermore, the inspection of pharmacies and the verification of prescription accuracy are strictly monitored by the Ministry of Health under this law.

II. Law No. 5510 on Social Insurance and General Health Insurance

Law No. 5510 is one of the regulations that governs the social security system and plays a significant role in combating prescription fraud. This law aims to prevent irregularities related to medicines and prescriptions obtained through social security institutions. Article 102 of the law regulates the sanctions to be applied in cases of abuse of the social security system.

Under this law, obtaining medication with forged prescriptions results in financial losses for social security institutions, and this can lead to sanctions such as administrative fines and exclusion from social security services.

III. Health Application Circular (SUT)

The Health Implementation Circular contains regulations regarding health services provided through social security institutions and plays an important role in combating prescription fraud. The Circular defines the rules to be followed in the processes of drug procurement and prescription issuance, and explains the sanctions to be applied in case of violations of these rules.

In particular, in cases such as the procurement of medicines with fraudulent prescriptions, administrative sanctions may be applied to healthcare providers under the SUT (Healthcare Services Pricing Regulation), and the contracts between these healthcare institutions and social security institutions may be terminated.

Council of State Decisions

The Council of State is one of the important judicial bodies regarding administrative decisions related to prescription forgery. In its rulings, the Council of State emphasizes the need to increase inspections related to forged prescriptions, particularly in public hospitals and healthcare providers.

For example, in one decision, the Council of State found it lawful to revoke the license issued by the Ministry of Health to a healthcare institution that supplied medicines with forged prescriptions. Such decisions demonstrate that administrative sanctions can also be effectively applied in the fight against prescription forgery.

IV. Prevention of Prescription Forgery: Legal and Professional Measures

I. Vocational Training and Awareness

One of the most effective ways to combat prescription fraud is to increase the professional training of healthcare professionals and raise awareness on the issue. Doctors and pharmacists should be trained on how to detect counterfeit prescriptions and informed on how to act when faced with such situations.

Pharmacists, in particular, should be vigilant when checking prescriptions and contact the prescribing doctor in suspicious cases. Furthermore, widespread adoption of digital systems for verifying prescription accuracy could be an effective method in preventing counterfeit prescriptions.

II. Legal Regulations and Sanctions

The effective implementation of legal regulations is crucial in combating prescription fraud. In this context, criminal penalties for those who issue counterfeit prescriptions or profit unfairly using such prescriptions must be deterrent. Furthermore, increasing the professional responsibility of healthcare professionals and tightening oversight should be among the measures taken to prevent prescription fraud.

III. Widespread Adoption of Digital Health Systems

The use of digital health systems can play a significant role in preventing prescription fraud. In particular, e-prescription systems can prevent the issuance and use of counterfeit prescriptions. This system enhances the accuracy and reliability of prescriptions by creating a digital communication network between doctors and pharmacists.

15th Criminal Chamber, Case No. 2017/30259 E., Decision No. 2019/3535 K.

"Case Law Text"

COURT: High Criminal Court
CRIME: Forgery of official documents, aggravated fraud
VERDICT: Acquittal

The judgments regarding the acquittal of the defendant on charges of forgery of official documents and aggravated fraud were appealed by the plaintiff's attorney, and the case was examined and the necessary considerations were made;
The defendant... forged documents in the names of rights holders he neither saw nor examined prescriptions organized by the defendants …, … and Firuzan Bingöl (İdemen) on behalf of … who benefited from health assistance after his death prescriptions They also arranged for the health records of the defendants ... and ... to contain antibiotics prescriptions In the case where the defendants are alleged to have caused harm to the institution by participating in the abuse of power and thus committed the crimes of forgery of official documents and aggravated fraud; based on the defendants' defenses, witness testimonies, and the entire case file, no conclusive and convincing evidence, free from all doubt, sufficient to prove the defendants' guilt was obtained, and the court's acceptance of the decision that the defendants' commission of the alleged crimes was not proven is found to be without error.
Based on the trial proceedings, the evidence gathered and presented at the decision-making stage, the court's conclusions and assessments in accordance with the prosecution's findings, and the scope of the examined file, the appellant's appeal regarding the substantiation of the alleged crimes is rejected, and the judgment is AFFIRMED unanimously on April 8, 2019.

V. Conclusion

Prescription forgery is a serious crime that threatens both the reliability of healthcare services and public health. The Turkish Penal Code and related legislation provide for significant legal sanctions against prescription forgery, and effective implementation of legal regulations is necessary to prevent this crime. Furthermore, increasing the professional training of healthcare professionals, expanding digital health systems, and tightening administrative controls will be important steps in combating prescription forgery. In this context, measures taken at both the legal and professional levels against prescription forgery will improve the quality of healthcare services and protect public health.

 

Student Intern

Behiye Zeynep Ozturk