“The Phantom Patients of CHEM”: Reported in an article “Reporter.lu” on Wednesday that “a group of CHEM geriatricians is under investigation on suspicion of forgery and subsidy fraud.” According to “Reporter”, serious allegations have been made against three geriatric physicians at the “Geriatric Center”.
The case is said to have been opened in 2017, when a doctor “alerted the management and medical council of the Escher Hospital seeking explanations about what in his eyes appeared to be a system of overcharging and abuse of his medical code,” according to “ Reporter.lu”.
“Doodles to forge signatures”
This doctor then decided to file a complaint. In 2018, the CNS was informed of the suspicion and referred it to the public prosecutor’s office “on suspicion of forgery, the use of counterfeits and subsidy fraud”. House searches were then carried out “in the CHEM and in the geriatricians’ practice in Dudelange, an annex to the CHEM”. When asked by “Virgule”, the public prosecutor’s office said that the investigation was “still ongoing”.
“In order to avoid cuts, the geriatrician had his patients admitted to the hospital under the name of another specialist, for example in the field of neurology, rehabilitation or general medicine, without this running through CHEM’s medical computer software. After the first three days in the hospital, the patient was demoted back to geriatrics,” a witness told Reporter.lu. He added: “At the request of one of the geriatricians who was dictating his instructions to me using a voice recorder, I made scribbles to forge signatures. Some recipes were acts of kindness.”
The accused geriatricians defend themselves against the allegations. “Reporter.lu” reports that “they are also hiding behind an ‘oral agreement’ that they reached in 2009 with one of the most important executives of the CNS, now retired, on the now criminalized method of invoicing.”
Eleven million fraud cases are processed by the CNS
On Friday, CNS President Christian Oberlé told RTL that he knew nothing about this oral exchange and had learned about it from the article quoted. On the other hand, regarding the issuance of counterfeit prescriptions, Christian Oberlé recalled that a system had been put in place to combat abuse and fraud. A system that, in his opinion, “has become more powerful over the past four years. We managed to process eleven million euros worth of fraud cases, this occurs in all systems and we probably have less of it than other countries.”
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The president of the CNS also noted that the current nomenclature “remunes volume and does not reward quality, whoever increases volume earns more than those who do not.” “The nomenclature of geriatricians is unfavorable to them, their remuneration does not reflect the complex work they do in relation to patients. The doctor’s time is poorly paid,” said Dr. René Metz, Director General of CHEM, told “Reporter.lu”. However, he stressed that “even if the nomenclature is poorly done, this is not a reason to make fakes.”
Meanwhile, lawyer François Prum, lawyer for two of the doctors affected by the investigation, claims to “Reporter.lu” that the nomenclature was adhered to by his clients. “After several years of investigation, the geriatricians have not been charged to date,” he said.
This text originally appeared at Comma. Translation and editing: Maximilian Richard
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2024-04-20 14:03:32