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HEALTH

Insurers say hospitals overcharge €1.5 billion

Wrong medical bills from clinics and hospitals are costing up to €1.5 billion a year, according to Germany’s statutory health insurers.

Insurers say hospitals overcharge €1.5 billion
Photo: DPA

The association of statutory insurance companies, GKV-Spitzenverband, said an audit showed that nearly half of all invoices submitted for reimbursement had mistakes in them.

“Last year, the proportion of hospital bills that we found contained errors, was higher than ever,” said Johann-Magnus von Stackelberg, from the Spitzenverband. He said it was possible the errors were now being discovered more often because insurance companies were getting more aggressive or because the hospitals were getting worse at submitting their bills.

“But the result is the same – far too many bills are wrong,” he said. A total overcharging of health insurance payers to the tune of up to €1.5 billion was not acceptable, he said. The insurers pay around €59 billion for inpatient care a year.

Incorrect medical bills have been a concern in Germany for years, with the Federal Audit Office even complaining about the problem this spring.

Examples of overcharging include a patient with a severe fungal infection whose hospital billed for an expensive drug when he was actually given one that cost €57,000 less.

In another case, an 82-year-old patient with a pelvic fracture was reported to have been given treatment that he never actually received, a discovery which saved insurance companies €11,700.

Stackelberg called for politicians to ensure, “that hospitals finally have a real incentive to bill properly.” Each incorrect bill should attract a fine of €300 per bill he suggested.

This last proposal was rejected by the German Hospital Federation (DKG) whose manager Georg Baum said the fact was that 96 percent of all cases regarding bills remained as they were despite intensive checks. “The questioned bills are overwhelmingly in cases of clashing medical opinion,” he said.

The effective rate of repayment was less than one percent, he said. The idea that the questioned payments adding up to €1.5 billion could be simply due to erroneous billing was “highly dubious”, he said.

The Local/DPA/mdm

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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