Corruption and Fraud in Health Care

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KKH- Allianz addresses corruption and fraud in the healthcare sector

According to the chairman of the health insurance company KKH-Allianz Ingo Kailuweit, the replacement insurance company suffered almost one million euros in damage last year due to fraud and corruption. According to other media reports, damage to the healthcare system in Germany as a whole is causing billions of euros.

The KKH Alliance, based in Hanover, is the fourth largest statutory health insurance company with two million insured persons. Chairman Ingo Kailuweit reported at a press conference in Hanover on Thursday that 818 new cases in the health care system were uncovered in 2009 due to corruption and fraud. With 228 times the investigators were most often active in physiotherapy and physiotherapy practices. Doctors were involved in 128 cases. The KKH Alliance reported 81 cases of home care. In the case of pharmacists, there were “only” 67 cases, but the damage amount was 270,000 euros. The dentists came in last, with 37 cases being investigated. Of the total damage incurred of EUR 913,470, a good half (EUR 500,763) has already been recovered. "Fraud in the health system must not be worthwhile and we are consistently pursuing it," said Kailuweit. The individual cases are treatments that have not been carried out, unauthorized cooperation between doctors and hearing aid acousticians, manipulated regulations, etc.

Most occurred in North Rhine-Westphalia with 146 cases, followed by Bavaria with 116 cases. From a nationwide perspective, criminal activities in the German health system are said to cause damage of up to 20 billion euros each year.

The KKH Alliance held a specialist conference on fraud in the healthcare system with 200 participants from February 17-18, 2010 in Hanover. Judges, public prosecutors, scientists, lawyers as well as representatives of health insurance companies and associations will discuss strategies for successful investigations and new scientific findings. Because despite considerable efforts, fraud and corruption in the German healthcare system continue to spread. The methods of illegal enrichment are becoming ever more diverse and skillful.

Unauthorized collaboration between doctors and providers of medical aids such as hearing aid acousticians and medical supply stores appears to be particularly widespread and questionable in the eyes of competition officials. Peter Brammen from the competition headquarters in Hamburg says: “A doctor may not earn any additional income through his prescription and recommendation practice.

In order to be able to take measures in the future, Jakob Stephan Baschab, General Manager of the Federal Guild for Hearing Aid Acousticians, already gives a possible direction: "Keeping the different service areas clearly separated from each other serves competition and consumer protection." (Thorsten Fischer, naturopath osteopathy, 20.02.2010)

KKH Alliance press release

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