Thousands of cases of billing fraud and corruption have been recorded by the general local health insurance companies within two years. This means a considerable additional burden for the contributors. The main focus is on the care sector.
According to the General Local Health Insurance Funds (AOK), corruption and falsified statements caused damage of around 73 million euros in 2020 and 2021. As reported by the AOK Federal Association, a total of 13,662 cases were pursued by the eleven AOKs in the reporting period. Details are in the so-called Misconduct Report 2020/21, which the association has now published.
The fraudulent behavior of individuals puts a strain on the contributors and causes considerable financial damage to the community of solidarity, said Susanne Wagenmann, chairwoman of the supervisory board of the AOK federal association for the employer side.
According to the information, the top priority, as in 2018 and 2019, is misconduct in nursing and home nursing. "In this area alone, 11.25 million euros could be secured for the insured community due to incorrectly and fraudulently billed services."
Reference is made, for example, to cases of organized crime in nursing services, where services that have not been rendered have been billed or services have been fraudulently obtained through "complimentary reports" from doctors. According to the AOKs in Germany, more than 27 million people are insured.
