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EU loses €56bn per year to healthcare fraud

EHFCN conference calls for co-operation between member states to reduce healthcare fraud and corruption

A total of €56bn is lost to healthcare fraud each year in the EU, according to research conducted by the European Healthcare Fraud and Corruption Network (EHFCN) in Belgium, France, the Netherlands, Northern Ireland, Norway, Poland, Slovenia and Scotland, and presented at the EHFCN annual conference on September 28-29.

'Healthcare shopping' was identified as a major source of fraud, due to the current lack of co-operation between customs, the police and healthcare organisations in exchanging sensitive information on tax and social security.

Examples of 'healthcare shopping' included people from the Republic of Ireland accessing free healthcare services designated for Northern Ireland residents by claiming false addresses, or a French patient living in Belgium claiming €9,000 a month for over 20 years, for expensive treatment that was not received.

In response, Laurette Onkelinx, Belgian Minister for Social Affairs and Public Health called on experts and all stakeholders to join forces and make effective use of the latest scientifically valid methods to measure and investigate cases of healthcare fraud and corruption, and to join forces to tackle it.

A law introduced in Belgium in 2007, which has enhanced the accountability of healthcare professionals and created a tool for the National Institute for Health and Disability Insurance (INAMI/RIZIV) medical inspectors to prevent and reduce losses due to fraud, error and waste, has realised a return of €8.5m in fines from 1,000 cases.

The conference also urged institutions to empower doctors and increase their transparency in order to encourage whistle blowing. It was felt that peer pressure could have an effect in richer countries and "survival corruption," as Dragana Jovanovic of Belgrade University put it, could be reduced in poorer ones.

A 'code of practice' based on agreed values relating to the receipt of gifts by medical professionals with which the industry may regulate itself was called for by some, with others favouring the banning of gifts altogether.

Plans to allow pharmaceutical companies to advertise medicines in newspapers were scrapped by MEPs last week, but one participant lamented the fact that doctors still receive a 'medical newspaper' filled with adverts twice a week.

Share of information was perceived key to addressing the problems of healthcare fraud and corruption. The EHFCN welcomed the initiative of the Belgian Presidency of the European Union to promote practical cross-border co-operation between magistrates in neighbouring zones for the request, use and exchange of information regarding tax affairs, social security, health and justice at an international level.

6th October 2010

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