Health insurance funds for Doctors in diagnosis of extra-cheat – t-online.de

try The German health insurance companies, to come about cheating in diagnoses of more money. The head of the largest German health insurance Fund of TK, Jens Baas, admitted in an Interview with the Frankfurter Allgemeine Sunday newspaper (FAS): “It is a competition between the funds who manages to bring the Doctors to be documented for the patients as many of the diagnoses.”

Then there is more money from the risk structure compensation. “The funds to pay, for example, premiums of ten euros per case for Doctors, if you make the patient on the paper sicker.” 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 for advice. For all this, they would have to spend in 2014, a billion Euro, the lack of for the treatment of patients.

suspected of longer

The mechanism is basically not new. In 2009, the so – called morbidity was introduced-oriented risk structure compensation – short-Morbi-RSA. He should create a balance for funds that have, for whatever reason, a more sicker clientele, and thus higher costs. Soon after, the suspicion that the funds of its members or Physicians make to their patients on paper sicker in order to get extra money sprouted.

direct Manipulation but apparently did not prove. With the statements of Baas now changed.

Some companies will get more money than you need

The TK-chief of the “FAS said” particularly intense, the regional funds would operate this can be considered cheating. “You can get 2016 expected to be a billion euros more than for the care of their Insured.” The coffers of the AOK, are meant, apparently, the newspaper writes.

But also his Fund could not escape the. However, the replacement funds, one of which is the TK would have to spend, this year, 700 million Euro less than you. 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.

cheating the refugees?

Baas criticized but also the Federal government. She wanted to keep the contributions in the election year of 2017, stable and transfer the funds, therefore, 1.5 billion euros from the health Fund. Justified, however, with the cost for the treatment of Flüchlingen.

“The refugees are an excuse. This is irresponsible, because it stirs up unnecessary resentment towards migrants,” said Baas. So far, the funds have costs almost no additional, because currently, in most cases, municipalities paid for the treatment.