Corruption: insider report reveals billion to fraud, with bogus recipes

if you sell drugs just to mention, services that were never provided, send unqualified workers to hospital beds, turn the mildly ill into serious patients or the healthy into

if you sell drugs just to mention, services that were never provided, send unskilled workers to hospital beds, turn mildly ill into serious patients or healthy in nursing cases. In order to extract billions of dollars from health insurance, fraudsters are very inventive. And, you’ll always want more. This is shown in the report of the Association of Health Insurance Institutes for the Federal Ministry of Health.

Around 40,000 case investigators led by AOK, Barmer and co. last year, the highest level in five years. In one year, almost a fifth of new criminal offences, more than 3300 criminal reports, were added, the investigators determined that a good 50 million euros were returned to the coffers of fraudsters, which is an increase of seven million euros compared to the previous year.

Too bad for. up to 14 billion euros.

However, this amount is only a fraction of the actual damage. Corruption experts estimate much higher sums of money. The Ministry of the Interior of Bavaria estimates the amount due to international experience at over 14 billion euros per year. However, whether there are more fraudsters in Bijela or they have just been exposed, I cannot say exactly. Controllers, such as the Medical Service of Insurance Funds (MDK), to detect more cases, because they can strictly consider, for example, nursing homes and outpatient services.

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In the case of medicines and care, according to the report, they will cheat the most. Both of them together account for a third of the cases, and a good half of the total damage. It is popular, slips of prescriptions are a problem, then doctors and Casinovale pharmacists cheat together. Sometimes the patient does. The doctor prescribes an expensive medicine, but instead of the Agent, part of the money paid by the Fund goes to the Patient; The rest of the doctors and pharmacists.

The report talks about “organized crime”

Cheating is also easy to cultivate. Many actors, such as care insurance funds, pension insurers, pension insurance offices or social authorities often work side by side, without consulting each other. Such as nursing homes and outpatient services that deal with patients, they can hardly be reasonable controls. The Landeskriminalamt in Düsseldorf recently stated in a report: “care fraud is characterized by an enormous increase in profits with a relatively low risk of detection.”

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recent care services in Russian have been particularly striking, especially in North Rhine-Westphalia and Berlin, as there are large Russian-speaking communities. Offender pay fees only on account, patients should simulate bribes Doctors or falsify documents. In the meantime, they establish fake companies in Switzerland and abroad, and develop hierarchical structures, so that “even evidence of organized crime”, – according to the fund’s report. The perpetrator is now focused on non-clinical intensive care, where, for example, patients in a coma are cared for. Money attracts, per patient, funds will pay up to 22,000 euros per month.

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perpetrators can become Difficult to camouflage easily

enlightenment is, for many reasons. Prosecutors and courts often lack accurate knowledge of social laws and contract law. Only four of Germany’s 16 federal states have the focus of prosecutions. The judge ordered a lot of procedures, because he is in the process, often only for small amounts. Funds often don’t learn what not to show from a criminal, as prosecutors will let you know. Perpetrators can easily disguise themselves. Those who have to face the closure of the care service in Bavaria due to fraud can try in Baden-Württemberg or Rhineland-Palatinate. The Fund’s comprehensive database of fraudsters at the national level is lacking. Finally, fund controllers do not often have to communicate all the results of their audits to competent corruption experts. The reason is that complex social laws.

Updated Date: November 29, 2018, 8:00 p.m

Categories: Optical Illusion

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