The record is impressive: 14 public prosecutors have uncovered many criminal offenses since the central office for combating fraud in the health care system was founded – especially in a sector that was actually supposed to provide more security.
Munich/Nuremberg (dpa/lby) – In the first two years since it was founded, the Bavarian Central Office for Combating Fraud and Corruption in the Healthcare System (ZKG) has already initiated 568 procedures. “It’s about protecting the health system against fraudsters. It’s not just about money, it’s also about health,” said Minister of Justice Georg Eisenreich (CSU) on Wednesday when the agency’s first work report was presented in Nuremberg. Fraudsters in the system could also damage people’s health.
By the deadline of October 30, 249 old procedures had been processed in addition to the 568 newly initiated procedures, and 524 procedures had now been completed. Between October 1, 2021 and September 30, 2022 alone, this led to 20 charges and 30 applications for penal orders in the Bavarian courts.
The Central Office for Combating Fraud and Corruption in the Healthcare System has existed since September 15, 2020 and is based at the Nuremberg Public Prosecutor’s Office. Since then, 14 public prosecutors led by Chief Public Prosecutor Richard Findl from Nuremberg have been investigating fraud and corruption in the health care system across Bavaria. Findl emphasized that the strong specialization of the investigative authorities and the good training of the investigators in Bavaria are now paying off.
Eisenreich emphasized that healthcare is an extremely large economic sector and that there are therefore many starting points for investigators of fraud and corruption. Last year, 466 billion euros were implemented in the healthcare system nationwide.
The largest group of suspects in the past twelve months were operators of corona test centers, said Eisenreich. “The ZKG has only been responsible for fraud with invented or incorrectly billed corona tests since June last year. 36 percent of the ZKG’s procedures are now related to the operators of corona test centers.”
However, the specialists also identified black sheep in other areas of the traditional health care professions: preliminary investigations against doctors accounted for 31 percent of the cases, with 10 percent focusing on physiotherapists and 9 percent on nursing services. In the area of ??billing fraud at corona test stations, exactly 107 procedures have been processed since the ZKG became responsible in June 2021.
The vast majority of cases (85 percent) involve fraud. In only one percent corruption is the allegation, it is also about document offences, money laundering and criminal offenses under the Infection Protection Act.
The investigators usually track down suspects through complaints from authorities and, above all, from statutory health insurance companies. But there were also reports from private individuals. About a year ago, the central office set up an online reporting system, which also received anonymous reports. “More tips than expected have been received. By September 30, 2022, there were 197 reports.” Investigations were initiated in 148 cases, and 22 reports even led to extensive investigations, said Eisenreich.
He emphasized that the central office, which is unique in Germany, could soon become a role model in other federal states – the conference of justice ministers had spoken out in favor of this. On the initiative of the Free State, the conference also called for increased on-site controls by the health insurance companies and a nationwide study of unreported cases. It is still very difficult to track down the scammers without external clues. “We still need clues.”
