They extorted tens of millions from the National Health Fund. The services broke the reimbursement gang

The nationwide activities of the services led to the breakdown of a gang extorting money from the budget of the National Health Fund. Due to the reimbursement of drugs, the gang extorted PLN 82 million. NFZ controllers interested, among others A sudden increase in the reimbursement of prescription reimbursement for pressure ulcers.

Investigators found that the gang members from September 2022 to December 2024 submitted nearly 40,000 to the National Health Fund. prescriptions, some of which were issued to fictitious patient data. Used, among others Personal data of social welfare homes and care and treatment facilities.

– The value of ingredients for the preparation of prescription drugs was inflatedwhich allowed you to obtain an undue refund. In this way from the NFZ budget at least 82 million was extorted zlotys – told the spokesman of the Central Police Investigation Bureau. Krzysztof Wrześniowski.

The services detained 21 people in the Pomeranian and Mazowieckie voivodships, including doctors, owners and pharmacies and entrepreneurs from the medical industry. CBŚP officers, acting together with NFZ controllers and representatives of pharmaceutical inspectorates, searched dozens of real estate. They secured documents, data carriers and property worth over PLN 2.5 million, including cash, gold, jewelry, exclusive watches and cars.

The detainees heard allegations of managing and participating in an organized criminal group and fraud. At the request of the prosecutor's office, the court applied arrest for eight suspects for three months. Other people got police supervision, property guarantees, contact bans and bans of leaving the country.

The operation lasted for months

The operation was preceded by the collection of evidence for months. He was also transferred to the prosecutor's office thanks to cooperation with employees of the NFZ Control Department and the General Inspector of Financial Information.

The National Health Fund announced on Wednesday that he interested the controllers, among others A sudden increase in the reimbursement of the ordinary recipe medicine.

In the case of one of the primary health care clinics in just three years, the refund value of the ointment on an ordinance in this entity increased 47 times (from PLN 230,000 in 2019 to PLN 10.8 million in 2022). Only in February 2023, this entity issued over 730 prescriptions to this ointment, which accounted for 83 percent. such prescriptions issued throughout the country.

NFZ controls also included pharmacies

-In the years 2022-2024, as a result of the control of the ordinance and pharmacies in the field of prescription drugs, we imposed financial sanctions in the amount of over PLN 15 million-said the director of the Social Communication and Promotion Office at the NFZ headquarters Paweł Florek.

The services also determined that the costs of ingredients for the production of prescription drugs were inflated despite the availability of much cheaper ready pharmaceuticals. In this way, the cost of the drug produced in the pharmacy (despite the ready -made ointments available on the market) increased from PLN 83 for a 100g tube to nearly 2 thousand. zloty.

The National Health Fund calculated that for the equivalent of unduly paid funds by the fund (at least PLN 82 million) could be financed: over 19,000 knee arthroscopy or over 17,000 coronarography or annual therapy for 159 patients with spinal muscular atrophy.

The case is developmental – investigators do not rule out further detention.

The campaign on the order of the prosecutor of the Department of Investigation of the District Prosecutor's Office in Zielona Góra was conducted by officers of the Central Police Investigation Bureau in cooperation with the National Health Fund controllers and voivodship pharmaceutical inspectorates from Gdańsk and Warsaw. (PAP)

Akar/ Mas/ Joz/