Monday, October 10, 2016

Health insurance billing fraud, health insurance companies will alert the Inspectorate – Sü


  • had sick brought insurance Doctors to make incorrect diagnoses, to collect more money, says the head of the technician health insurance.
  • The Federal insurance office has condemned the alleged payroll fraud in focus.
  • Other insurance companies rejected the accusations vehemently.
By Kim-Björn Becker and Thomas Öchsner, Berlin/München

convicted of The Federal insurance office has the alleged payroll fraud on the part of statutory health insurance funds focus. When Doctors from the health insurance companies will be encouraged to document false diagnoses, is to bind the “unlawful and under,” said the Bonn authority. At the same time, it announced that each and every individual case, to investigate if a possible misconduct of a Fund is known. The municipal hospitals are required immediately, prosecutors should initiate investigations. It is a matter of “unjustified” payments to the funds.

the chief of The technician health insurance (TK), Jens Baas, had said in an Interview with the Frankfurter Allgemeine Sunday newspaper, there is between the funds, a competition to bring the Doctors to document as many as possible diagnoses. “The funds to pay, for example, premiums of ten euros per case for Doctors, if you make the patient on the paper sicker.” The funds wanted to receive more money from the health Fund into which contributions flow. This provides for a balancing of risks: funds with healthier members need to support the competitors with many seriously ill patients. Baas said, the funds would get by cheating a billion euros. Involved especially the “large regional funds”. He meant probably the coffers of the AOK but also the TK itself.

SPD-health expert: “instructions for a criminal Offense”

of The SPD-health expert Karl Lauterbach called the actions of the funds, without delay, inform. The above-mentioned practices could be a “instructions for a criminal Offense,” said Lauterbach, the süddeutsche Zeitung. Under certain circumstances, patients could come to harm, because they would be incorrectly treated. The managing Director of the Guild funds, Jürgen Hohnl, called the System of money allocation by using the so-called risk structure compensation “susceptible to manipulation”. It is known that in structure of support contracts between a health insurance company and of the respective physicians ‘ Association in a Federal state “under the guise of better care for diagnosis of extra money to Doctors will be paid”. Such a contract for Insured persons of a Fund in Berlin in the SZ.

Other health insurance companies rejected the allegations of the TK Executive Board, heads vehemently. In the case of the DAK-health, as well as the Barmer GEK, it was said that funds would entice Doctors to make patients sicker than they actually are. The chief of the AOK-Federal Association, Martin Litsch said, Baas wants to bring the issue of risk equalisation in disrepute, and for the benefit of the technician, and reform. “Apparently

The German Foundation for patient protection turned to their own information, a criminal complaint at the Prosecutor’s office in Hamburg against the TK, and other funds. Foundation chief, Eugen Brysch, said possible criminal liability for serious fraud.

fake allegations against health insurance companies

the head of The techniker Krankenkasse told by dubious methods of insurance. Therefore, Doctors get bonuses to make on the paper sicker than you are. It costs billions. more…


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