Clinics cheat insurance funds

Many private clinics in Athens and Thessaloniki have been making illicit profits by charging patients’ insurance funds for bogus equipment and operations, according to recent checks by health inspectors. The most recent incident to come to light is that of a major life insurance firm being charged 5,200 euros for an operation carried out on a beneficiary, who accidentally stapled her hand. The woman is alleged to have been given a general anaesthetic and obliged to stay at the clinic overnight so that her insurance firm could be charged the maximum possible amount. The same clinic is alleged to have charged patients’ insurance funds for expensive medical tests and scans that were never performed. In Thessaloniki, two leading private clinics are alleged to have been systematically claiming payment from insurance funds for stents that were actually never used. Stents are tubes commonly used in coronary and vascular surgery. According to inspectors, these clinics would submit claims for 9 to 12 stents per operation, when guidelines issued by the European Society of Cardiology cite a European Union average of 1.2 stents used per operation. The two clinics are alleged to have profited by between 18,000 and 20,000 euros per operation through this scam. Meanwhile, one branch of a chain of private clinics in the Athens district of Psychico is alleged to have been charging an insurance fund for an inordinately high number of pacemakers. In one year, 195 pacemakers are alleged to have been fitted by just one doctor, health inspectors noted in a 2006 study, remarking that even state hospitals with two cardiology clinics do not report such a high rate of pacemaker implantation.

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