Another Social Security scam busted. This Wednesday, April 11, 2018, eight nurses, an oncologist and the manager of a medical equipment company in Val d’Oise (95) were brought before the courts, suspected of having embezzled 3 million euros from the Caisse. Primary Health Insurance (CPAM) local.
It was patients who sounded the alarm: surprised to see medical procedures never performed (!) appear on their care sheets, they had warned the Health Insurance. At the end of March 2018, the investigation had led to the detention of the 10 accused by the gendarmerie.
A nurse and her husband at the heart of the Social Security scam
The scam, organized around a couple – a nurse and her husband, manager of a medical equipment company – was well established: fictitious medical acts, overbilling, false prescriptions… In total, the damage suffered by Security social security is estimated at 3 million euros by the gendarmes. But investigators from the Val d’Oise gendarmerie group add 1.8 million euros of abuse of corporate assets.
“A system of kickbacks paid directly into personal accounts allowed the main respondent and her husband to enrich themselves,” say the investigators. “These are facts that are as illegal as they are amoral. These individuals were taking advantage of very sick people, who were going to die. »
In order to “restore the accounts of the CPAM”, the Pontoise public prosecutor’s office proceeded to the precautionary seizure of the equivalent of 1.12 million euros in the form of real estate, vehicles and cash belonging to the 10 individuals implicated . These will be tried before the Pontoise Criminal Court on January 30 and 31, 2019.
This case is unfortunately not an isolated case: according to a report by the National Delegation for the Fight against Fraud, 149.4 million euros of fraud were detected by the Sécu in 2012 – and the biggest frauds come from mainly liberal health professionals.
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