Medical institutions commit fraud: they ask for money from sick funds for the care of dead people

Doctors continue to demand all kinds of illegal premiums from patients, and dentists also commit fraud.

Provided 260 services per day

Private and public medical institutions, according to the management of the Sick Fund, are demanding millions of euros from the fund for services they did not actually perform. Especially in recent years, nursing services at home have become popular, when the medical institution collects almost 20 euros for each real or only supposed visit of a patient, so they even care for the dead.

“There are falsifications, it was submitted for payment and it was declared that services were provided to dead people, to those who are receiving treatment in a hospital,” the chairman of the Seimas committee, Antanas Matulas, testified.

“The record sounded – one employee entered it [duomenis]that provided 260 services per day. This is impossible,” said Tatyana Golubajeva, head of the State Sick Fund.

Last year, Health Insurance Funds paid 30 million for nursing home services. euros, which is twice as much as two years earlier. The Health Insurance Fund also receives a lot of inflated bills from dentists.

“Instead of performing prosthetic work on a person’s entire mouth, one tooth is prosthetic, and the entire amount is served for payment,” A. Matulas gave an example.

“Inflated prices, presented for higher compensation from sick funds, services are provided by those who do not have the right – not doctors, but technicians,” said T. Golubajeva.

Charges for free services

Medical institutions also abuse their patients with illegal surcharges for services that should be free.

“Institutions do not even provide the opportunity to receive the service without a premium, this is the standard in some institutions. This is a large group of violations”, emphasized the head of the State Health Insurance Fund.

Dozens of private and public medical institutions, suspected of embezzling funds from the Mandatory Health Insurance Fund, are now in the sights of law enforcement officers.

“A pre-trial investigation by the Special Investigation Service (STT) is underway. We are conducting an anti-corruption assessment and we will also conduct an assessment of corruption risks and present our proposals”, said Elanas Jablonskas, deputy director of STT.

The manager of the state health insurance fund explained that after checking only 1%. payments, found illegal for just over half a million euros and will now try to recover them. And he claimed that he refused to transfer 3 million euros last year after realizing that the accounts were fraudulent.

“We can’t put a controller next to every service provider and patient,” T. Golubajeva explained.

During the year, doctors in the country come into contact with patients about 70 million times, so it is impossible to check all the bills submitted by them.

“Irregularities are found in a huge amount of services during inspections every year,” assured Deputy Minister of Health Aurim Pečkauskas.

The opposition blames the chairman of the commission

The chairman of the Seimas health protection committee, Antanas Matulas, blames the State Sickness Fund for the fact that fraudulent doctors are able to cheat millions of euros from taxpayers’ money.

“This has been going on for a number of years, although the problem worsened because new services were introduced in nursing homes, and funds for dental prosthetics were increased,” A. Matulas taught.

However, the opposition representatives also blame the chairman of the committee for not being able to stop the embezzlement of money from the sick coffers during his four years in office.

“Conservatives have influential people who run, have run or are the founders of famous private clinics. Normally, no Seimas would pass through this barrier, because the pressure reached the Speakers of the Seimas”, claimed the peasant Aurelijus Veryga.

As millions of doctors are being extorted from the Sick Funds, as the elections are approaching, those in power are already threatening to impose criminal liability on doctors, to revoke their operating licenses for malicious violations, and they are calling on the Sick Funds to cooperate more closely with FNTT and STT.

More on that in the video above.