They had never worn the expensive compression stockings, but they had acknowledged the reception. In exchange for a small reward, patients in need of care are said to have helped in the fraud of health insurance funds.
The sensational scandal about the suspected million-dollar false billings with care services is being heard since wednesday in dusseldorf at the regional court. Prosecutors put nine men and women in the dock on charges of gang fraud. One of them, a female captain, has already made a comprehensive confession, says prosecutor petra szczeponik.
The damage is estimated by investigators to be at least 8.5 million euros. The defendants are alleged to have billed health insurance companies and social security agencies for services that were not provided at all or not provided in full. Four of them are in custody under investigation. According to the court, most of them came from russia and the ukraine.
The predominantly russian-speaking patients had often even helped to collect money, according to the prosecutor: sometimes in the form of a three-figure monthly allowance, sometimes a cleaning lady was sent to them from time to time if they confirmed the expensive compression stockings, including regular dressing by a nurse. Another scam: the drugs allegedly administered by a nurse were taken by the patients themselves.
The "free services" were even advertised in russian-language newspapers, the prosecutor reports. If prufer had inquired, the "patients" had been robbed of what services they had to declare and allegedly received properly. The compression stockings were also put on – for the first time.
"It was already very organized," prosecutor says. Because the number of caregivers was far lower than necessary for the services billed, the companies had "employed" bogus employees whose job consisted of signing forms.
Doctors who prescribed unnecessary medication are said to have been in cahoots with the defendants and to have cashed in as well. However, it has not yet been possible to obtain a statement to this effect. "None of them will talk to us," says the prosecutor.
That russian or ukrainian mafia groups were behind all this was not proven in this trial, says prosecutor. One had often heard: "that’s what everyone does."
In order to bring the machinations to justice, undercover investigators from the state criminal investigation office had even been used, who met with the nursing care bosses in dusseldorf disguised as investors.
The ultimate sufferers, she says, were the taxpayers and the people with health insurance. Nationwide, 230 outpatient care services are suspected of fraudulent billing. According to an earlier estimate by the federal criminal police office (BKA), the social security funds could have suffered losses of at least one billion euros per year.
The patient protection foundation called for a leniency program for confessed insiders. It was necessary "to dry up the swamp of the care mafia". So far, the regional court has scheduled 27 trial days until shortly before christmas.