Conference calls for improved cooperation in fighting fraud and corruption in healthcare and social security
Thursday 6th October
Money lost to social and healthcare fraud takes huge proportion. In 2010, EHFCN estimated that 56 billion euro were lost annually to healthcare fraud and error in the European Union (1). According to the French Ministry of Social Affairs and Employment , social fraud detected in 2010 reached more than 457 million euro (twice as much as in 2006), of which the biggest amounts concerned the healthcare insurance (156 million), the Social Security Central Agency (ACOSS – 186 million) and family allocations (90 million). (2)
Money is not only lost to healthcare fraud and corruption; more money is lost to waste, which in the healthcare sector for example, is due to over-prescription, medical errors malpractice and lack of quality in health services. To date it is still difficult to evaluate the total losses due to waste across the European Union. Some studies in the US indicate that the annual cost of measurable medical errors that harmed patients in the US in 2008 amounted to 17.1 billion dollars (3). In 2009 another study estimated that the total loss to fraud, error, overconsumption and inefficiencies in the US reached 700 billion dollars (4).
EHFCN regrets that comparable figures are not available in Europe. Just a few days ago, on 21/09/2011, Transparency International Germany criticised the federal government that reliable figures related to the number of cases of fraud, abuse and corruption which were found in healthcare in Germany, the number of reimbursements and of prosecutions had been lacking for years (5).
Paul Vincke, President of EHFCN, said “In the context of the financial crisis which hits Europe and the world it is high time to recognise, assess and reduce this economic burden which drains unacceptable amounts of money from public resources. We call on decision makers at national and at European level to devote more attention and to give more means to eradicate this phenomenon”.
Although healthcare and social security systems are different throughout the member states, fraud processes share similarities and strategies .Methods to counter them are generically and technically speaking the same for both sectors. Some of the most important frauds involve both sectors. An example is identity fraud which gives access to undue unemployment and healthcare benefits.
“This is why the focus of the conference is not only on the fight against fraud in healthcare but on the fight against fraud in social security as well”, Paul Vincke added. “We hope the conference will inspire people from both sectors to join forces. It is only by joining forces that we can hope to curb losses and improve counter fraud strategies and expertise within our respective countries and across Europe.”
References
(1) Gee J, Button M, Brooks G; The financial cost of healthcare fraud; University of Portsmouth, MacIntyre Hudson, EHFCN, 2010.
(2) Portail de la Sécurité Sociale ; http://www.securite-sociale.fr/institutions/fraudes/fraude.htm, accessed 3/10/2011
(3)Van Den BosJ, Rustagi K, Gray T, Halford M,Ziemkiewicz, Shreve J; Health Aff April 2011 vol. 30 no. 4 596-603
(4) Kelley R: White paper – Where can 700 billion in waste be cut annually from the U.S. healthcare system? Thomson Reuters, 2009
(5) http://www.transparency.de/2011-09-21-Stellen-zur-Bekaemp.1964.0.html?&contUid=4084
Notes for news editors
EHFCN is the only organisation dedicated to combating healthcare fraud and corruption across Europe in order to bring back money to healthcare services for the benefit of every patient. EHFCN provides information, tools, training and assistance in fighting fraud and corruption and offers a platform for its current 18 member associations to exchange information and ideas.
EHFCN's 8th Annual Conference took place in Krakow on 6-7 October on the theme “Fighting fraud in healthcare and social security – How to maximise results?” Around 140 participants from 15 countries representing Ministries of Health and of Social security, sickness funds, unemployment funds, academics, healthcare providers and industry are expected to take part in the conference.
EFHCN also took this opportunity to confer its third Excellence Awards to “Doctors Against Corruption”, Serbia, and to Dr Pierre Fender, Director of dispute settlement and the fight against fraud for the French National Health Insurance Fund for Salaried Workers (CNAMTS).
Further information can be found at www.ehfcn.org.