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VHI €30m victim of overcharging, erroneous payments or possibly fraud, since 2006
By Finfacts Team
Sep 17, 2013 - 4:11 AM
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Source: FBI
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VHI, the State health insurance company, has discovered overcharging or
erroneous payments to hospitals and doctors that have amounted to €30m since
2006.
The Irish Times
reports today that the company said that overall it recovered
€10.5m in 2012 through the actions of its special claims investigation unit (€6.9m) and
its third party recovery process (€3.6m).
The newspaper said that it did not reveal details of the
identities of the hospitals and doctors found to have been overcharging although
the sums involved had to be repaid. It said none of the cases of overcharging
had been referred to the Garda.
Its special claims investigations unit (SIU) had recouped a total of €30m
since its establishment in 2006.
It's likely that there is some fraud involved but note the contrast
compared with social welfare fraud.
The US Federal Bureau of Investigation says on its
website:
Health care fraud costs the country an estimated $80bn a year. And it’s a
rising threat, with national health care spending topping $2.7tn and expenses
continuing to outpace inflation. Recent cases also show that medical
professionals are more willing to risk patient harm in their schemes.
The FBI is the primary agency for exposing and investigating health care fraud,
with jurisdiction over both federal and private insurance programs. We use our
analytic expertise to identify key trends and tap into our investigative
partnerships with federal, state, and local agencies, as well as our
relationships with national groups and associations, to uncover fraud. Our field
offices also proactively target fraud through coordinated initiatives, task
forces and strike teams, and undercover operations."
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