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Allegations of investigators: policy fails in the fight against care fraud

2019-09-27T16:11:31.448Z


Every year, criminal care services commit billions of dollars and endanger the lives of patients. Investigators and health insurers are now calling on the government to do more to stop the fraud in care.



Bavaria's Minister of the Interior, Joachim Herrmann, estimated that around € 14 billion last year, and criminals withdraw from health care every year. About two billion of these are likely to be spent on outpatient care services that care for the elderly and the sick at home.

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But the fight against fraudsters has been a rather half-hearted policy. Health insurance companies and investigators therefore feel left alone by politics. "The political decisions against the fraud in the nursing remain on the surface.That is pure actionism," said Dominik Schirmer, chief investigator at the AOK Bavaria, the SPIEGEL. Only in the intensive care services, with which cooperates the AOK Bavaria, determined against 35 of 120 providers the prosecutor.

  • ( "The enemy on my bed" : Read here how home care services plunder the health insurance and exploit the plight of families.)

Although the former Federal Minister of Health Hermann Gröhe (CDU) had announced 2016 stricter laws and more resources in the fight against the caricature fraud. But since then, "not much has happened," criticized prosecutor Ina children, which is responsible in Berlin for the fight against nursing crime.

Even Gröhe's successor Jens Spahn (CDU) was previously guilty of clear guidelines. Spahn had recently suggested that ICU patients should usually be hospitalized or cared for in residential care homes instead of at home because of better quality control. But clear legal requirements - for example, for the necessary qualifications of the nursing staff - and to harsh controls so far.

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The lack of qualified nurses promotes fraud: care services sometimes hire auxiliary staff, but reckon on the cashier with qualified and therefore correspondingly expensive skilled workers. However, the lack of competence can be a danger to the seriously ill patients.

Investigators of the Criminal Investigation, which are supposed to get the fraudsters on the loose, frustrated above all the lack of staff in the authorities. They often have to leave notes and documents behind for years because of the lack of resources, and the prosecutors and courts lack employees who are struggling through the jungle of care. "We can only hope to achieve respectable results with our procedures and judgments, which at least have a deterrent effect," says Kriminalhauptkommissar Karsten Fischer, which investigates in Berlin against caregivers.

The investigators are dreading the consequences of increased recruitment of nurses abroad: "Who should then check whether their qualifications are sufficient and correct?" Asks prosecutor children. "That's not possible now."

This topic comes from the new SPIEGEL magazine - available at the kiosk from Saturday morning and every Friday at SPIEGEL + and in the digital magazine edition.

What is in the new SPIEGEL and what stories you find at SPIEGEL +, you will also learn in our free policy newsletter DIE LAGE, which appears six times a week - compact, analytical, opinionated, written by the political minds of the editorial.

Source: spiegel

All business articles on 2019-09-27

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