A nurse suspected of fictitious care in the amount of 1.3 million euros

A nurse suspected of fictitious care in the amount of 1.3 million euros

The contours of this new case of fraud against health insurance funds were revealed yesterday afternoon on the information site Zinfos 974. A few months ago, CGSS inspectors in La Réunion discovered with surprise that one 61-year-old liberal nurse, founded in Saint-Denis, is paid for daily medical practices for a staggering amount. Verifications were made that made it possible to establish that the woman had to work days of up to 96 hours to do this.

A complaint was therefore filed with the public prosecutor’s office in Saint-Denis and the investigations were entrusted to the research section. The gendarmes carefully examined the works exchanged by the CGSS for the benefit of the nurse’s office for three years. This is how many cheat mechanisms are updated. The liberal nurse was in the habit of being replaced by 3 or even 4 colleagues during her absence. Which is strictly prohibited. If it is possible to have several collaborators, his succession should be made stricto sensu by one person. One of the people who work punctually in the company is not even declared.

Prescriptions are made

But this is not the only tactic used by the sexagenarian to increase his income in an amazing way. Investigators discovered that he made a disturbing practice of disguising the prescriptions given to patients by their doctor in order to increase the number of actions prescribed. These fictitious treatments correspond to the same false movements. Likewise, some excerpts from the works are abusive.

Most of the fraudulent practices attributed to dishonest nurses have been detrimental to the CGSS. Over the course of three years, the estimated amount of embezzlement was around 1.2 million euros. Specifically in this case, social security is not the only victim. The soldiers realized that the Old Age, Disability and Sickness Insurance Fund (Cavimac) is also the victim of the nurse. This one actually counts among its clients a convent located in Providence.

The nurse also works in a convent

Like other patients, the sisters are visited by the nurse in the heart of where they live. There again, he multiplied the works prescribed by the nuns like hotcakes. The same care can be billed twice or even three times with multiple trips involved. For Cavimac, the damages are estimated at 80,000 euros. The squandered money would have allowed the nurse to lead the way, especially by taking fancy trips around the world.

Before the holidays in the south, the gendarmes checked the nurse’s office in Sainte-Clotilde. Some almost fabricated prescriptions were seized. Her substitutes, doctors and patients were heard as witnesses to support the charges against the nurse.

A deposit of 400,000 euros

At the end of his police custody, the ruffian dressed in white was brought to the prosecutor’s office in Saint-Denis on July 16. He left the court with a summons to appear in court to answer for his actions on November 15. He was also placed under judicial supervision. Until her trial, she is prohibited from exercising her profession as a nurse but also from interacting with the health personnel she works with.

In addition, the judge of liberties and detention ordered the payment of a deposit of 400,000 euros. He also confirmed the confiscation of cash amounts from his bank accounts in the amount of approximately 100,000 euros. For the nurse, squeezed a year from retirement, the increase promises to be salty.

Eric Laine

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