January 18, 2010 / 12:19 AM / in 9 years

Factbox: Types of healthcare fraud around the world

(Reuters) - Some 180 billion euros ($260 bln) is lost globally to fraud and error in healthcare, according to a study by the European Healthcare Fraud and Corruption Network and the Center for Counter Fraud Services published on Monday.

Here are some examples of healthcare fraud from across the world:

Healthcare professionals

* Two doctors were found to have claimed a government improvement grant for their clinic which they then spent on setting up a car import-export business.

* Dentists have been found to have claimed for dental work they didn’t do, for gold fillings which were actually mostly composed of nickel, and for opening their clinics out of normal hours without doing so.

* Opticians have been found to have claimed fees for carrying out sight tests on people who were subsequently found to be dead or non-existent.

* Pharmacists have been found to deliberately divide up prescriptions into small packages to claim extra fees.

Drug companies

* Drugs giant Pfizer was ordered to pay $2.3 billion in September 2009 in America’s largest healthcare fraud settlement for making false claims about prescription medications.

* Drug companies have also been found to organize cartels to restrict the supply of key drugs and artificially raise prices.

* Equipment companies have been found to supply counterfeit diagnostic equipment, and there is a serious global problem concerning the supply of counterfeit drugs.

Patients and the public

* Organized criminals have been found to establish bogus medical clinics to bill insurers for healthcare treatments that are never provided and to have stolen confidential patient data for use in credit card fraud.

* Patients have been found to lie about their economic circumstances to get free treatment, to pretend they are resident in certain countries where they were entitled to free treatment and claim expenses for hospital journeys never made.

Managers and staff

* Managers or staff employed by healthcare organizations have gained employment or advanced their careers by claiming false employment histories or qualifications.

* One finance manager was found to have put his family on the payroll of the healthcare organization he worked for.

* One chief executive of a healthcare organization was found to have over-claimed on his mileage allowance by 55,000 miles.

* Hospitals have been found to claim falsely they undertook surgical procedures to attract extra payments.

SOURCE: Report on global healthcare fraud by European Healthcare Fraud and Corruption Network and the Center for Counter Fraud Services.

Compiled by Kate Kelland; Editing by Charles Dick

0 : 0
  • narrow-browser-and-phone
  • medium-browser-and-portrait-tablet
  • landscape-tablet
  • medium-wide-browser
  • wide-browser-and-larger
  • medium-browser-and-landscape-tablet
  • medium-wide-browser-and-larger
  • above-phone
  • portrait-tablet-and-above
  • above-portrait-tablet
  • landscape-tablet-and-above
  • landscape-tablet-and-medium-wide-browser
  • portrait-tablet-and-below
  • landscape-tablet-and-below