- Financial misconduct involving falsified accounts amounting to 1.8 million euros in Bavaria
Misconduct in the Health Sector
An instance of fraud, estimated to be around 1.8 million euros, occurred in Bavaria in 2023, impacting the KKH Health and Nursing Insurance, as they themselves reported. When compared to other federal states, Bavaria tops the list, with Schleswig-Holstein trailing behind with approximately 800,000 euros in damages, as per a spokesperson's statement. Across the nation, the overall damage totals around 3.5 million euros.
Fraud and dishonest practices are prevalent throughout the healthcare system, affecting various sectors such as the use of fake caretakers, counterfeit medications, misuse of insurance cards, billing for non-existent treatments, and forged professional certifications. This impact spans from doctor's offices and pharmacies to nursing homes, hospitals, and physiotherapy clinics.
Nationwide, the costliest cases for KKH involve fraudulent claims from outpatient care services, amounting to nearly 1.9 million euros. The pharmaceutical sector ranks second with over a million euros in damages.
In 2022, KKH reported 553 new cases nationwide. With 76 cases, Bavaria holds the second position, behind North Rhine-Westphalia which reported 128 new cases.
Questionable Practices
KKH's chief investigator, Emil Penkov, stresses that a few individuals engaged in such wrongdoings are simply spoiling the reputation of their profession. These individuals often act without conscience and may even endanger lives to illegally amass substantial sums of money.
As per a Forsa poll commissioned by KKH, 58% of Germans aged 18 to 70 have either encountered fraud in the healthcare system themselves or know someone who has.
KKH relies on tips from various sources, including the Medical Service (MD), other health insurers, and the police, to uncover these crimes. However, according to Penkov, "Anyone can report suspected fraud to the health insurers."
The alarming prevalence of corruption in the healthcare system includes cases of fraudulent claims from outpatient care services in Bavaria, contributing significantly to its total damage of nearly 1.9 million euros. This corruption not only tarnishes the reputation of the affected professionals but also poses a risk to patient safety, as some individuals may engage in dishonest practices to illegally amass money.
