Misconduct in the healthcare system: billions in damage caused by fraud

Misconduct in the healthcare system: billions in damage caused by fraud

The report from AOK Rheinland/Hamburg shows that the pharmaceutical and dressings service areas were particularly affected by fraudulent activities. With damage amounting to around 3.5 million euros, this area accounted for the largest share of the total damage. In addition to the service providers, third parties could also be active in the pharmaceutical sector and try to obtain certain medications through forged prescriptions. Home health care was also affected by fraudulent behavior, causing damage of around 1 million euros.

In the last two years, AOK Rheinland/Hamburg has reported a total of 1,485 cases of misconduct, of which 669 cases are new from this period. The remaining cases were already known and are either being processed or criminal proceedings are ongoing. Compared to previous years, the fund has investigated a total of 72 more cases.

Not only has the number of healthcare fraud cases increased in the last two years, but the crimes are also becoming increasingly complex. The CEO, Günter Wältermann, emphasizes the need for effective measures to counteract this form of white-collar crime. There are calls for specialized police and judiciary units to be set up to adequately investigate reported cases.

The chairmen of the board of directors of AOK Rheinland/Hamburg, Wolfgang Ropertz and Günter Roggenkamp, ​​reiterate the call for dark field studies in order to uncover the actual dimensions of cases of misconduct in the healthcare system. It should be noted that known cases probably only represent the tip of the iceberg and further scientific studies are necessary to adequately address this issue.(userData)