Fraud security : a couple of nursing has diverted 1 million euros

Health 5 July, 2017


Published the 05.07.2017 at 12: 38


Keywords :

fraudeAssurance maladieinfirmier

Acts or movements overcharged, care fictitious… For 4 years, a couple of nurses girondins was defrauded of the Caisse primaire d’assurance maladie (CPAM) of the Gironde and two other organizations. The fraud would amount to 950 000 euros. They were tried by the tribunal correctionnel de Bordeaux on Monday, 3 July.

The public prosecutor has requested a one-year suspended prison sentence and 20,000 euro fine against the nursing. His wife, risk, it, 6 months suspended prison sentence and 5,000 euro fine. The couple could also be sentenced to a prohibition to exercise of 5 years. The case was taken under advisement on September 18.

They appear to ” scam to have overcharged for the acts of nurses, charged for acts that they would not have made, surcoté acts, carried out acts fictitious and travel expenses overcharged in patients “, described to AFP their lawyer, Henri-Michel Gata.

A monthly salary of 40 000 euros

During the investigations, the investigators have identified many irregularities. In view of the number of acts charged, in particular, they felt that the nurses had to work an average of 20 hours per day, 366 days a year to pocket as much of the agent. They have also noted that 10 000 acts charged in third-party payment had never been made. Through this sleight-of-hand, the couple is said to have affected up to 40 000 euros monthly, according to newspaper South West.

To their lawyer, the couple is not the only culprit. He explains, in effect, that the system is not very clear and encourages this type of situation. “It is more difficulties in understanding the nomenclature of the CPAM, which may be very unclear and subject to interpretation on the part of nurses, as a real determination of fraud. It is a culpable negligence, there have been approximations”, he justified.

In any case, the national Council of the College of nursing sees things differently. In 2016, the nurse has been sentenced to 24 months of prohibition of the exercise. He would have entrusted his patientèle to his wife.