Healthcare providers can have a wide range of opportunities to engage in fraud and corrupt activities. Examples include, but are not limited to fraud and corruption by:

General Practitioners

• General Practitioners claiming for patients they have actually not treated.

• General Practitioners creating details of patients for treatment under state-funded or discounted health schemes that do not exist.

• Medical professionals lying about their qualifications to receive fees or higher salaries that they are not entitled to.

• Medical professionals separating out various aspects of treatment to give the appearance of numerous procedures and for the purpose of billing the paying authority more.

• Medical professionals asking for and receiving an informal payment from patients awaiting treatment, generally under the understanding that they would then receive the treatment quickly.

Staff at hospitals

• Staff member submitting falsified timesheets claiming for hours not worked to receive a higher wage packet

• Payroll staff creating fictitious staff members and diverting the wages or salaries into bank accounts they have access to.

• Staff member providing fictitious qualification details to obtain a promotion or pay rise.

• Manager falsifying performance statistics to receive a larger pay bonus.

• People successfully applying for jobs using falsified qualifications, references or work experience.

• Managers diverting funds from their business area for their own personal use.

• Senior management signing off altered or fictitious financial statements as correct.

Other healthcare providers

• Dentists charging patients privately and also submit claims to the health insurer.
• Opticians claiming that two pairs of glasses were issued to a patient when only one pair was actually issued.
  
• Physiotherapists claiminign for services not performed or claiming more services than actually supplied.
  

Pharmacists

• Pharmacists substituting expensive drugs with a cheaper alternative, but claiming for the expensive one.
  
• Pharmacists adding items to prescriptions.
• Pharmacists selling medicines without prescription to wholesalers for illegal export.
• Pharmacists invoicing non-delivered drugs.
  

It is important to be aware that fraud and corruption can take many different forms, and that the perpetrators committing these crimes are always looking for new openings through which to commit them.

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