A few weeks ago, Karl Lauterbach (SPD) had big plans. “Cheating should no longer be worth it,” said government circles about the Federal Minister of Health’s plan to end the gigantic fraud in rapid corona tests with strict controls. The previous “gold rush mood” of private test stations, which siphon off state funds in the millions, if not billions, with false accounts, must finally come to an end. Lauterbach wanted to clear up this legacy of his predecessor Jens Spahn (CDU).
Now it looks like little will remain of this much-heralded venture. Lauterbach’s ministry sent a nine-page draft to the federal government and the federal states on Tuesday on how to proceed with the rapid tests. With this draft, Lauterbach confirms its intention to commission the Robert Koch Institute (RKI) with the analysis and verification of the accounts. So far, the associations of statutory health insurance physicians have been responsible for this.
The problem with the matter: The RKI, which plays a central role in the fight against the pandemic, is not created for this at all. A kind of financial police would be needed to stop fraud in rapid corona tests. The main tasks of the RKI are Fighting infectious diseases and the “analysis of long-term health trends in the population”. The Berlin-based institute describes itself as an “early warning system” – as far as health risks for the country and people are concerned. There can be no talk of an early warning system against fraud at the RKI.
Hundreds of investigations are ongoing across the country
The invitation to cheat should therefore continue. The state has so far paid around twelve billion euros for rapid corona tests, but the private operators of the many thousands of test stations have hardly been checked. The result: hundreds of investigations across the country because numerous stations are said to have billed a large number of tests that did not take place. The courts have imposed the first prison sentences for fraud, and other suspects are in custody.
At the Berlin State Criminal Police Office, Jörg Engelhard heads a commissariat that deals almost exclusively with billing fraud during corona tests. He now estimates the damage caused by fraudulent citizen tests nationwide at more than one billion euros. Engelhard thinks it is incomprehensible to transfer accounting control to an institute like the RKI, which has no experience with it. In addition, it is unclear who will take care of the probably many millions of fictitious tests that are said to have been billed so far. “This is about billions in tax waste that has so far only been insufficiently processed,” he says.
The Berlin investigator has even more objections. “The RKI should give the local health department information if data is conspicuous. But then the health department would have to carry out a tangible check and, for example, request the addresses of those tested,” says Engelhard. “I can already see the fax machines glowing.” The RKI itself says that it has expertise in statistics and mathematics and can find “anomalies in data sets”. The necessary structures for the rapid test control “are currently being set up and the first evaluation approaches are being tested”.
The RKI cannot refuse this task
That sounds reassuring. But you have to know that the RKI is subordinate to the Ministry of Health and is bound by instructions; so cannot refuse such a task. Unofficially, there is talk of an “air number”. You have neither the resources nor the technical knowledge to find black sheep among the private rapid test operators.
And there is something else: The Ministry of Health does not want to give the RKI any additional money for the additional work. A “financial compensation for other actors” in addition to the associations of statutory health insurance physicians is not planned, the ministry said on request. The new draft regulation from Lauterbach states that the Robert Koch Institute will incur costs “of an unquantifiable amount” for the audit.
It is difficult to understand that the ministry wants to keep the RKI financially short. Since May, the associations of statutory health insurance physicians have received a flat rate of 2.5 percent of the billing amount for each corona test, previously it was even 3.5 percent. Since the citizen tests have cost the state around twelve billion euros so far, around 400 million euros flowed to the associations of statutory health insurance physicians for payment and control alone. They should continue to receive the flat rate, even if they are no longer supposed to check the citizen tests in the future. “There are no plans to change the administrative cost rates of the associations of statutory health insurance physicians,” said Lauterbach’s ministry.
The task is gone, the reward remains
The Berlin investigator Engelhard thinks it sends the wrong signal that the Associations of Statutory Health Insurance Physicians are released from the task of examining, but we should continue to receive the same remuneration. “That seems to me like a gift to the Association of Statutory Health Insurance Physicians and is not logical in itself, because the question inevitably arises as to how valuable the test has been up to now if the same money is paid in future without a test,” he says.
The National Association of Statutory Health Insurance Physicians itself already fears being held liable for failure to carry out billing checks. The public prosecutor’s office in Berlin is currently examining whether the board of directors of the local Association of Statutory Health Insurance Physicians may have made themselves liable to prosecution because they checked the accounts too laxly or not at all. In many places, associations of statutory health insurance physicians have currently stopped paying out the amounts to the rapid test centers and are waiting for the new regulation. While up to one billion euros per month have been transferred to the rapid test centers in recent months, according to the latest figures, it was only 152 million euros last month.
According to information from NDR, WDR and SZ, the fraud is likely to continue. The test ordinance that has been in force since the end of June provides that a deductible of three euros is often due for a citizen test. In some cases, people who are examined for the corona virus even have to bear the costs completely themselves. However, it is usually enough to tell a test station that you are visiting relatives in a nursing home or friends in the hospital, and you will get the test for free. The operator of a nationwide chain of rapid tests reports that more than 90 percent of visitors to its stations would provide such information and would continue to get the tests for free. The new draft does not show how the RKI should investigate such fraud in the future. At best, the minister knows that, according to the institute.