SCHIEDAM – The central government must do more to tackle health money fraud. It is gradually becoming too easy for malicious parties to start a business in, for example, district nursing and cheat the tax and premium payer. There is no risk, says Aad de Groot from DSW.
The director of the Schiedam health insurance hopes for two concrete initiatives from the ministry: to test the results of starting entrepreneurs and to impose fines on those who make a mistake.
De Groot will convey these two tricky points to Health Minister Conny Helder tonight. He meets her in the TV studio for the program Renze, which will set aside a topic for fraud with the health care system.
DSW is trying to do a lot about health fraud, says De Groot. “We have a team of ten people who are constantly working to tackle scammers.” He believes this makes his insurance company the party that makes the greatest effort to combat abuse among competitors. Yet it is all too often reminiscent of open-mouth mopping, especially since the decentralization brought about by the Health Insurance Act. “A district nurse, for example, makes the indication for the care that people need. It must be independent. ” But nothing prevents him or her from cheating things by, for example, prescribing a lot of care that is not necessary and is not performed.
In addition to district nursing, mental health care is also susceptible to fraud, says De Groot. Anyone who wants to raise money maliciously can set up a business in those sectors and go his way without major consequences. “It is very easy to start a healthcare business. All you have to do is register with the BRIC, which is under the supervision of the Ministry. It does not test. ” Starting a healthcare business is easier than opening a snack bar, De Groot has argued for some time.
And that needs to change, he will tell the minister. In the health care system as a whole, it is estimated that about one percent of the money is lost through fraud. “But you know it’s almost a billion.” Dutch healthcare is about eighty billion euros annually.
The DSW director proposes to do the same for small start-ups as for larger ones. “If you start with ten employees, you get tested.” But if you start with a few and then quickly grow to hire ten or more people, you avoid any control. Why not hold every foster parent’s baptismal cell up to the light? De Groot believes that one factor that will play a role is the desire to keep market access open. “It’s good for the competition, good for the healthcare system, that’s probably the reason. But it is better to check closer in the beginning and then give confidence. This leads to less administrative burdens. And then there are restrictions on data exchange, it sounds. Then arrange it! ”
So: test also the smallest start-up entrepreneurs – on diplomas, organization, a possible criminal history or previous bankruptcies – which De Groot will submit to Minister Helder. “As far as I am concerned, a person who has committed fraud should never start a healthcare company again.”
And make sure something is at stake. “Now it is risk-free fraud. Once fraud has been detected, we have no choice but to request a refund. And it’s already hard enough, because the bird has usually flown. Make sure that in addition to the recovery, we can also impose a fine. ”
That is, De Groot compares, as if to say ‘Schiedammers: you have to pay for parking in the city, but if you do not and you get caught, you have to pay the amount you should have put in meters. ‘. “Well, then soon no one will pay for parking.”
According to De Groot, a fine system is also quite easy to implement. “And then we put the money that we receive in a pot, from which we properly fund extra care for the vulnerable. That money should not really go to the health insurance. ”The pot will probably not be that big either. “But fines will act as a deterrent.” And it can prove to be the rescue of the system – plus the assurance that honesty pays off, and that does not cheat.
De Groot can be seen in the Renze program, from quarter to ten on RTL 4.