news Billions fraud of pharmacists with air recipes
Tuesday, 10.05.16 , written by Kathrin Staats Pharmacists are said to have cheated health insurance companies with so-called “air prescriptions”. The prosecution is already investigating in several federal states because pharmacists have submitted incorrect prescriptions to the coffers. The damage caused
Pharmacists abuse the trust of patients
Recently, serious cases of fraud were reported by nursing services. Among other things, they should have invoiced services that were not provided. Now the pharmacists are also targeted by the prosecutor . According to the Welt am Sonntag is currently being determined in several states, as pharmacists have submitted so-called ” air recipes ” in the statutory health insurance. These are prescriptions from patients for whom pharmacists receive money from the health insurance funds, but do not spend the medication on patients. But even though the prosecutor has now started work, the likelihood of detecting such fraud is extremely low.
Air Recipes: Pharmacists cheat health insurance
If pharmacists receive a prescription from patients, they settle this with the statutory health insurance companies. The funds trust the pharmacists and refund their costs. But some pharmacists do not give the drugs to patients according to recent reports, but collect with so-called “air prescriptions” only the money . Doctors themselves can be part of the scam .
The MDR reports a case in Frankfurt, where a doctor is said to have issued thousands of prescriptions for expensive medicines. Her life partner brought these prescriptions to a pharmacist, but this one handed out much cheaper products. The surplus money of the funds kept the pharmacist, while the partner of the doctor sold the cheap drugs abroad.
But not only doctors, but also patients should be involved in fraud cases . For example, patients refrain from using the medications prescribed by the doctor and sell the prescription to pharmacists. This in turn then cuts the cash of the cashier.
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Apotheker fraud cases: damage amount in the billions
Due to the fraud cases of the pharmacists, the health insurance companies incur a considerable financial loss. In 2015, they spent a total of 35 billion euros on medicines alone. Up to € 2.72 billion may have been overpaid by drug fraud and corruption , according to Transparency International.
Although the coffers last revealed fraud cases in the amount of about 16 million euros, reports the Süddeutsche Zeitung. But most offenses are rare. This opinion is also health economist Gerd Glaeske. He even suspects a much higher number of unreported cases, the world reports on Sunday. “There are usually few connoisseurs in these constellations of criminal energy of individuals , and as long as they stick together and do not blaspheme each other, there is little chance of it escalating,” Glaeske said.
“Air Recipes”: Pharmacists Association speaks of individual cases
A spokesman for the Federal Association of German Pharmacists Associations (ABDA) told the Deutsche Apotheker Zeitung (DAZ) that there is no evidence for a scam, but rather one has to assume individual cases . From the point of view of the ABDA, the so-called “air recipes” are thus a small problem . Instead, President of the ABDA Friedemann Schmidt explains in an interview with the MDR that only the health insurance companies have access to all data. Therefore, Schmidt sees the coffers in the duty to investigate cases of fraud .
A spokesman for the GKV-Spitzenverbandes warns the news agency dpa that “air recipes are scams to the contributors. And, what is almost worse, they undermine the patients’ trust in the medical profession and the pharmacists. “In addition to the fraud and the loss of trust of the members, this has further consequences. Healthcare spending has been increasing for years. If these frauds are not stopped, this may have a negative impact on membership fees.
The GKV-Spitzenverband calls for a harder crackdown on these illegal activities . He continues to criticize: “We need more specialized prosecutors in Germany, so that fraud and corruption in health care can be better combated.”
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- Kathrin State
- editorial staff
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