A nurse suspected of defrauding Social Security for nearly a million euros

Legal information was opened on Tuesday against this liberal nurse from Ain. A case which is far from being an isolated case.

In just a few years, this infimier would have accumulated a nice jackpot. A practitioner of Ain working in liberal is accused of having defrauded the health insurance to the tune of more than 880,000 euros, according to AFP. A judicial investigation was opened Tuesday against him, for “fraud and aggravated fraud”. The facts would have taken place between 2011 and 2015, always according to the same process: the nurse overcharged acts or billed others that he had not carried out by producing false invoices.

The case is far from isolated. Examples abound of practitioners having defrauded Social Security in this way. Last week, a pharmacist in the Lyon region was, for example, indicted for falsifying prescriptions and false invoices for more than two million euros. In June 2015, it was still a nurse who had been arrested, also suspected of a fraud of one million euros.

Professionals, the first fraudsters in health insurance

Sentences can go as far as imprisonment. This is the case with this nurse from the North, sentenced in January 2015 to three years in prison, one of which was closed for having defrauded 732,000 euros from the Primary Health Insurance Fund, via double or even triple billings, falsification of prescriptions and overbilling of acts. According to Northern voice,, it is the fact that this nurse declared five times more fees than the average of nurses in the region which put the chip in the ear of the Health insurance. And again, the software of the Primary Health Insurance Fund could not go back, in this specific case, until 2009 …

, Health Insurance detected, in 2014, 196 million euros in Social Security fraud, a figure up 17% over one year, a historic record. A sign that controls have intensified. Over the past ten years, nearly 2,900 healthcare bans have been issued against professional fraudsters and 2,600 have been sentenced to prison. In 2014, health professionals had in fact diverted 37% of health insurance fraud. Policyholders, for their part, are only responsible for 20% of fraud.

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