W Olsztyn completed the process of a known dentist who over the years falsifying medical records and extort refunds from National wellness Fund. The court sentenced her to 1 year in prison., and besides ordered a turn almost half a million zlotys.
A fraud mechanics – how did a dentist bargain money?
Teresa R.-M., holding a contract with the NFZ, offered patients reimbursement of dental treatmentbut in reality charged additional feesand subsequently reported the same benefits to NFZ as free. In any cases she hasn't performed any treatments at all.And yet She's been making fictional reports..
The investigation revealed that in years 2009-2017 in the dentist's documentation approximately 2.8 000 patientswho allegedly benefited from the refunded services. In fact, patients They paid for it.Or they never visited the office.
Among the abuses included:
- forgery of documentation of treatments specified as tooth removal, tooth varnishing or reconstruction,
- charging for services to be reimbursed,
- reporting to the NFZ benefits that have never occurred.
A full dentist obtained this way 497 1000 PLN of undue refund, which constituted a serious breach of the terms of the contract with the NFZ.
The court sentenced the dentist – what consequences?
During Teresa R.-M.'s trial. She confessed. And she gave in voluntarily. Olsztyn territory Court he agreed to the defence's motion, given that the dentist declared to repair the damage.
Judgment:
- one year suspended for 3 years,
- 10 1000 PLN fine,
- obligation return PLN 497 thousand NFZ.
Although the case active extortion several 100 1000 zlotys, the court found that the conviction of imprisonment was suspended will be sufficient.
Is the conviction fair? Expert opinions
The dentist's case triggered large agitation in the medical community. any experts indicate that specified fraud undermine assurance in the refund system and may lead to NFZ control exacerbations Doctors.
On the another hand, voices appear that the conviction It's besides mild.. As 1 commentator notes, falsification of medical records and fraud of public funds should be punished more severely, especially erstwhile fraud lasted for respective years and active thousands of patients.
Is the NFZ going to strengthen doctors' controls?
This case is another example of abuse of the NFZ refund system, which has increasingly revealed in fresh years extortion cases. In consequence to akin fraud, the fund announces increased control Doctors and medical facilities.
The NFZ may introduce:
- More frequent audits of documentation,
- new benefit verification mechanisms,
- stricter penalties for doctors who commit abuse.
Such changes are intended to increasing transparency in the refund system and defend patients from unfair practices.
The Teresa R.-M. case shows how easy it is in the NFZ refund strategy fraudwhich for years stay unnoticed. Although a dentist has been convicted, many experts believe that penalties for extortion of public funds should be more raw. NFZ announces increased controlBut is that adequate to effectively halt akin fraud in the future?
Read more:
Dentist extorted money from the NFZ – conviction passed
