health insurance companies manipulate in the billing of services on a large scale. The chief of the techniker Krankenkasse (TK), Jens Baas, this cheating in a conversation with the “Frankfurt General Sunday newspaper”.
“and pay The funds, for example, premiums of ten euros per case for Doctors, if you make the patient on the paper sicker,” said Baas. Some of the funds would visit the Doctors in person, others called. There are even agreements with doctors associations, which have more and more serious diagnoses to target. The funds were also in this direction of business consultants to advise what fees were incurred.
For all the would spend the funds in 2014, one billion Euro, the lack for the treatment of patients, said the head of the largest German statutory health insurance. Without the manipulations, the rate of contribution of TK 0.3 percentage points might be low. “I would like that the System is resistant to manipulation is made,” said Baas to justify why he is making the cheating of his and of the other funds open to the public.
The financial situation of the statutory health insurance funds is a sensitive topic: political parties, trade unions and employers to argue about who bears the greatest burden in the financing of the statutory health insurance. An analysis of the individual arguments and the cost items shows that the Insured carry significantly higher loads than the employer. This imbalance is likely to intensify in the coming years.
Baas said the newspaper continues, it would be helpful to clarify whether the method was illegal. A supervision would not exist in this case. “The Federal insurance office and the state regulators see it differently and do not act uniformly.”
more money from the risk structure compensation scheme, created a competition between the funds, “who manages to bring the Doctors to be documented for the patients as many of the diagnoses,” said Baas. “From a slightly high blood pressure is a serious. From a mood of depression, a real Depression, that gets 1000 euros more a year per case.”
Particularly intensive would operate the regional funds, this can be considered cheating. “You can get 2016 expected to be a billion euros more than you need for the supply of their Insured.” Baas means, apparently, the coffers of the AOK, the newspaper writes. But its Fund could not escape the.