A dermatologist has been hit with a hefty €30,000 fine after being found guilty of submitting fraudulent claims to the General Healthcare System (Gesy), according to the Health Insurance Organisation (HIO).
The doctor was found to have entered incorrect or unjustified claims for reimbursement into the Gesy software, as discovered during an investigation conducted by the HIO last month. The investigation revealed that the dermatologist recorded medical procedures under different codes for services that were never actually provided.
The fine is the largest among a total of €49,100 imposed by the HIO on 51 healthcare providers, including general practitioners, specialists and pharmacists. The HIO shared details about the fines on the official Gesy website this Wednesday.
In addition to the dermatologist, two other specialists, a urologist and an orthopaedist, were also penalised with fines of €800 and €300, respectively. The urologist was found to be conducting procedures in a non-compliant facility, while the orthopaedist exceeded the referral limits for physiotherapy services set by the HIO.
A further €16,500 in fines was levied against 47 general practitioners for overprescribing medication and issuing an excessive number of physiotherapy referrals. According to the HIO, these doctors prescribed unnecessary quantities of medication beyond what was required for a month’s supply and issued physiotherapy referrals without adhering to clinical guidelines.
The fines for the general practitioners ranged from €300 to €500. The HIO emphasised that the medications prescribed were “excessive and not medically necessary,” with some doctors issuing new prescriptions while previous prescriptions for the same products were still valid.
A pharmacist was also fined €1,500 for dispensing more medication than prescribed. According to the HIO, the pharmacist provided patients with unnecessary or excessive quantities of medicine, which exceeded their monthly needs and violated the instructions of the prescribing doctors.
The publication of the fines imposed during the month of September was part of the HIO’s decision to inform the public about the checks conducted within the national health scheme and the actions taken by the organisation to combat abuse.
