If the patient still suffers from the same condition as they did when the 1 yr expires. It would be unrealistic for any Dr. to say in their professional judgment, opinion, the patient no longer has a qualifying condition when the scientific medical evidence shows otherwise. see People v. Windus....the attorney general of cali. tried that one already. and lost.

So yes, defrauding is the only legal logical reality.....unless the patient is faking the condition claimed in the first place.