Financial Crime World

Fraud in Netherlands’ Healthcare Industry: “Hundreds of Millions” Siphoned Off, Warns VNG

The Dutch healthcare sector is experiencing a significant financial loss due to rampant fraudulent activities, according to a new report by local authorities organisation VNG.

Significant Financial Losses

  • The assessment, the first of its kind, estimates that taxpayers are losing “hundreds of millions of euros” through deception within the industry. (VNG)

Structure of the Dutch Healthcare Sector

The Dutch healthcare sector comprises thousands of small enterprises providing care services, including:

  • Community nursing

  • Psychiatric care

  • Youth coaching

  • Residential care

  • Funded by local authorities and health insurance companies, often through Personal Care Budgets (PGBs)

  • Individuals have the freedom to purchase services according to their needs

Prevalence of Fraud in the Healthcare Sector

  • Criminal companies fraudulently claim reimbursement for hours not worked
  • Services never rendered

Effects on Vulnerable Populations

  • The most vulnerable populations are disproportionately affected, especially individuals in sheltered accommodation and those requiring personal assistance

Detecting and Dealing with Fraud

  • Local authorities assumed responsibility for distributing healthcare funds in 2015
  • Lack resources to detect fraud
    • “Hardly any checks are carried out to ensure people receive the help they’ve paid for”
    • Even easy-to-reach groups, such as the elderly with dementia or young people with mental impairments, can be taken advantage of
  • In 2022, only 113 cases of fraud were reported to local authorities
    • Figures could be much higher due to a complex care provider network
  • New law enabling local authorities to share data and take effect in 2023
    • Will enhance their ability to detect fraud
  • Current efforts to combat fraud in the healthcare sector are falling short
    • The likelihood of being caught is minimal

Previous Cases of Extortion and Sex Trafficking

  • Two years ago, the health ministry published a report revealing several small care organisations in Twente had coerced vulnerable clients into:
    • Working on marijuana plantations
    • Engaging in sex trafficking

Recommendations

  • Health economics professor Wim de Groot stressed the need for local authorities to expand their staff to effectively oversee care providers
  • Insufficient resources and manpower hinder the detection of fraud

Additional Resources