A dentist from southern Bavaria is said to have wrongly billed the Bavarian Association of Statutory Health Insurance Dentists for a total of 19 million euros. The Bavarian Central Office for Combating Fraud and Corruption in the Health Care System has now brought charges against him in 20 cases for gang-related fraud. The Nuremberg-Fürth regional court must decide whether to allow the charges, the Nuremberg Public Prosecutor’s Office announced on Thursday.
The list of allegations against the man is long: In addition to the fact that he no longer worked as a dentist and still billed for treatments, the main issue is the accusation of “abuse of the form of cooperation”. Between 2013 and 2017 he is said to have created a total of 20 false quarterly statements.
Presumably most of the services billed for were provided during this time, but under false pretenses. Resident doctors can either be the sole owner and operator of a practice and then employ doctors there, or they can also set up so-called joint practices or practice groups. The modalities of service billing vary depending on the organizational form.
The accused is said to have operated several dental clinics externally in the form of practice groups – i.e. as a group of dentists in their own practice who share equipment and administration. In fact, the investigators accuse him, the dentists were all employees of the accused.
According to the Association of Statutory Health Insurance Dentists and the Central Office, this abuse of the form of cooperation means that all dental services amounting to millions should not have been billed – even if they were all provided in this way. The investigation was initiated by one of the employed dentists. The accused has remained silent so far.