Investigation points to total damages of EUR 10m
The National Anticorruption Directorate (DNA) prosecutors have conducted searches on Thursday at the National Health Insurance House (CNAS) and at the Bucharest Health Insurance House (CASMB), judicial sources say.
DNA has informed on Thursday it has conducted searches at 50 sites, of which two of them are public institutions in Bucharest, in a file regarding deeds committed during 2016- August 2017.
“The National Anticorruption Directorate prosecutors – the Anticorruption Section, is conducting investigations in a criminal file regarding suspicions of corruption deeds or assimilated to corruption, during 2016-August 2017. Following the legal authorisations from the competent court, on August 31, 2017 searches are being conducted at 50 sites, of which two of them are the offices of two public institutions in Bucharest, the rest being offices or working points of some companies or domiciles of individuals,” the DNA release reads.
DNA searches at the National Health Insurance House and its subsidiary in Bucharest aim at settling fictitious home care services, involving CASMB officials, protected by the heads of the two institutions, sources say. Injury is of over RON 13 million (approx. EUR 3 million).
In connection with the settlement of healthcare services by the Health Insurance House of Bucharest, the activities were carried out on three levels.
The first level targets the defrauded amounts from the funds of the Bucharest Health Insurance House (CASMB), through the “settlement of fictitious home care services based on hundreds of fake medical files,” media sources say. CSAMB officials reportedly have been involved, under the protection of some of the heads of the institution, but also individuals from the management of the National Health Insurance House (CNAS), the sources say.
According to the sources, there were many situations when “priority for approval and settlement was given to the medical files with fictitious patients, while the demands of insured patients who were actually entitled to receive home medical services were refused.”
In order to hide the traces, those involved allegedly have falsely produced monthly reports of medical services required for the settlements, while entering and deleting data from the CNAS’s computer system through unlawful access, so that the system would show that the medical services had been actually carried out, sources say, the damage found by investigators being of about RON 13,200,000.
A second level investigated by prosecutors refers to suspicions that officials from the National Health Insurance House and the CASMB, including with control and contravention finding positions, allegedly have claimed benefits from the representative of a company providing medical services (home medical assistance), in exchange for giving up, in the future, the excessive control on the company, the sources add.
Another lead checked by DNA refers to a Court of Audit control, when people in the system tried to conceal the situation of fictitious patients’ settlements. In this situation, medicine amounting to RON 33,000,000 (approx. EUR 7 million) would have been settled “by fraudulently drawing up medical documents that would create the impression that the irregularities found by the Court of Audit were within an exception provided by certain rules that were allegedly elaborated by CNAS,” the sources cited quote.
The offenses investigated are bribe taking, influence trafficking, constitution of an organized criminal group, deception, abuse of office if the official has obtained for himself or for another undue benefits, intellectual forgery, false documents under private signature, use of forgery, IT forgery.
Total damages thus amount to approx. EUR 10 million./IBNA