Other healthcare providers

Spectacles over-prescribed, even for dead patients (UK)

In the UK, a business providing domiciliary ophthalmic services claimed reimbursement of their services to the National Health Services (NHS) for the testing of patients' eyesight and the subsequent provision of spectacles.

While a clinical review of the services provided raised serious concerns in relation to the standard of care, an initial fraud investigation identified a number of fraudulent claims: indeed, patients had died previous to the alleged examination claimed. Further investigation revealed negligent practices including the signing of blank claim forms and the alteration of clinical records from previous examinations in order to justify further reimbursement claims when no further testing had actually taken place.

The ratio of claims for the provision of spectacles to examinations was almost double the regional and national average. Many of these claims prescribed and claimed for reimbursement for two pairs of spectacles where actually only one pair had been provided. 

In all the investigation concluded that around one third of all claims made by this business were false or inaccurate.