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J Dessin1

  • 1LKA Berlin, Germany.

Der Internist
|May 28, 2017
PubMed
Summary

Law enforcement agencies in Germany have varied experiences with healthcare billing fraud. Hamburg and Rhineland-Palatinate possess the most extensive knowledge of this criminal activity.

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Area of Science:

  • Criminology
  • Forensic Accounting
  • Public Health Policy

Context:

  • Experiences with healthcare billing fraud vary among German state police departments and the Federal Criminal Police Office.
  • Significant expertise in addressing healthcare fraud is concentrated in Hamburg and Rhineland-Palatinate.
  • The emergence of specialized investigative units in other federal states during the mid-1990s was driven by unique case complexities, such as the "Herzklappen" and Berlin "EG Medicus" investigations.

Purpose:

  • To document and analyze the varying levels of experience and expertise in combating healthcare billing fraud across different German law enforcement agencies.
  • To identify key regions and historical cases that have shaped the investigative approaches to healthcare fraud.
  • To provide a basis for understanding the development of specialized units dealing with complex financial crimes in the healthcare sector.

Summary:

  • Law enforcement agencies across Germany report diverse experiences with healthcare billing fraud.
  • The Landeskriminalamt (State Criminal Police Office) in Hamburg and authorities in Rhineland-Palatinate have accumulated the most substantial experience.
  • The mid-1990s saw the establishment of investigative units in other federal states to address specific manifestations and complex cases of healthcare fraud, exemplified by "Herzklappen" and the Berlin "EG Medicus" investigation.

Impact:

  • Highlights the need for knowledge sharing and standardized training in combating healthcare fraud nationwide.
  • Informs the strategic allocation of resources and expertise within law enforcement agencies.
  • Provides historical context for the evolution of investigative techniques against financial crimes in the healthcare sector.

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