90 people, companies sent to court in illegal medical service reimbursements case in Romania

The National Anticorruption Department (DNA) sent to court 90 defendants in a case targeting illegal medical service reimbursements in Romania, in which the damage amounts to over RON 20 million (EUR 4.3 million).

59 of the defendants are individuals, such as persons from the management of the National Health Insurance House (CNAS), the National Health Insurance House of Bucharest (CASMB) and officials from these institutions, while the rest are health care companies. Among them, Marian Burcea, director of CNAS at the time of facts, who was detained in early September 2017. He was then investigated under judicial control.

The prosecutors say they all participated in illicit activities through which more than EUR 4.3 million was taken from the funds of the National Health Insurance House of Bucharest through fictitious house medical care services.

According to DNA, a group of companies offering home medical care, together with officials of the National Health Insurance House (CNAS) and the National Health Insurance House of Bucharest (CASMB) “turned home medical care into a profitable business with total disregard for law and patient rights.” They allegedly obtained the Personal Numeric Codes (CNP) and medical records of persons insured with CASMB, and then used this information to falsely create files for home medical care. They also used the health cards fraudulently to record the medical services for reimbursement, although these services were never provided or were provided under illegal conditions.

The money reimbursed by the CASMB based on these files was embezzled by administrators of home health care providers, being spent on personal interest and paying members of the criminal group, the prosecutors said.

Starting March 2017, the criminal group was supported by the president of the National Health Insurance House (CNAS), Marian Burcea.

In the fall of 2017, when news about the case started to appear, the local media presented horrendous details about the reimbursement of medical services. For example, managers of the insurance houses denied home care requests for people who were in serious condition or unable to move, while defrauding the institutions.

Irina Marica, irina.marica@romania-insider.com