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Manipulation of the accounts Health insurance companies urge doctors to multiple diagnoses
Corruption and healthcare fraud are not really new. But what the boss of the largest German health insurance now reports is hard to believe. Apparently the coffers are cheating in a big way. They urge physicians to make more diagnoses on patients.
Cheating on diagnoses on a grand scale
Only a few months ago it was reported that because of millionaire prescription fraud of pharmacists is determined. And in the summer, the AOK Bayern had discovered a million-dollar fraud. So, healthcare fraud is not really new. But only about manipulations in a big way is reported. According to a report of the "Frankfurter Allgemeine Sonntagszeitung" (FAS), the German health insurances are trying to gain more money through cheating on diagnoses.
According to a newspaper report, the German health insurance companies are trying to gain more money by cheating on diagnoses. According to him, there are contracts with doctors who have more and more serious diagnoses as their goal. (Image: marcus_hofmann / fotolia.com) More money from the risk structure compensation
According to a report by the news agency dpa, the head of the largest German health insurance fund TK, Jens Baas, admitted in an interview with the FAS: "There has been a competition between the health insurances over who manages to get the doctors to care for the patients as much as possible to document many diagnoses. "
It is said that there will be more money from the risk structure compensation. "The health insurance funds, for example, pay premiums of ten euros per case for doctors if they make the patient on paper sicker." According to the information there are even contracts with medical associations, which would have more and more serious diagnoses as the goal.
In addition, the funds were advised in this direction by management consultants. For this they have spent since 2014 one billion euros, which is missing for the treatment of patients.
Especially regional cheats cheat
According to Baas, this cheating would be carried out particularly intensively by the regional funds. "In 2016, they expect to receive one billion euros more than they need to care for their insured persons," said the TC chief of the "FAS". According to the newspaper, the cash registers of the AOK are obviously meant.
Cashier does not take out TK
But his cash register could not escape that. Nevertheless, the Ersatzkassen, which includes the TK, this year would be 700 million euros less than they spend. It is said that the contribution rate of the TK could be 0.3 percentage points lower without the manipulations.
"I want the system to be tamper-resistant," says Baas, explaining why he's exposing the cheating of his and the other coffers.
Government unnecessarily fuels resentments
Baas criticized in the interview, the black-red federal government, which wants to keep the contributions in the election year 2017 stable and the funds therefore 1.5 billion euros transferred from the health fund.
The reason given is the billion-dollar cash injection with the costs for the treatment of refugees. But Baas sees it differently: "The refugees are an advanced reason. This is irresponsible because it unnecessarily fuels resentment of migrants, "said the TK chief. The coffers would have so far almost no additional costs, as currently usually pay the municipalities treatment. (Ad)