Corruption and fraud in healthcare

KKH Allianz addresses corruption and fraud in the healthcare sector

The KKH alliance, based in Hanover, is the fourth largest statutory health insurance company with two million insured persons. Chairman Ingo Kailuweit reported on Thursday at a press conference in Hanover that in 2009 818 new cases in the health sector had been uncovered by corruption and fraud. With 228 times, the investigators were most often active in physiotherapeutic and physiotherapy practices. In 128 cases physicians were involved. For home care, the KKH Alliance reported 81 cases. There were pharmacies „just“ 67 cases, but here a loss amount of 270 000 euros to book. The final blow was the dentists, where in 37 cases was determined. Of the total incurred 913,470 euros damage, was already good half (500,763 euros) have been brought back. „Kailuweit has stated that it is not worthwhile pursuing fraud in the health care system, "said Kailuweit, referring to the lack of treatment, unauthorized cooperation between physicians and hearing care professionals, manipulated regulations, etc.

In North Rhine-Westphalia, 146 cases occurred most, followed by Bavaria with 116 cases. Nationwide, damages of up to € 20 billion a year are due to criminal activities in the German health care system.

The KKH alliance held a symposium with 200 participants on 17 to 18 February 2010 in Hanover for fraud in the healthcare sector. Judges, prosecutors, scientists, lawyers and representatives of health insurances and associations discuss strategies for successful investigations and new scientific findings. Despite considerable efforts, fraud and corruption in the German health care system are becoming ever more frequent. The methods of illegal enrichment would become more diverse and skillful.

Illicit collaboration between physicians and providers of medical devices, such as hearing care professionals and medical supplies, seems particularly widespread and questionable in the eyes of competitors. Peter Brammen from the Wettbewerbszentrale in Hamburg says: „A doctor may not obtain additional earnings through his prescription and referral practice.

In order to be able to take measures in the future, Jakob Stephan Baschab, chief executive of the Federal Guild of Hearing Aid Acousticians, has already given one possible direction: „Keeping the various service areas clearly separate serves competition and consumer protection.“ (Thorsten Fischer, Naturopath Osteopathy, 20.02.2010)

source
Press release of the KKH Alliance