Irish Economy
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

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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