All municipalities in Twente will extensively check care providers before they receive a new contract.
“We are opting for a reinforced approach, on all kinds of fronts,” said Almelo alderman Eugène van Mierlo (CDA). RTV East† “Healthcare fraud is at the expense of vulnerable people, precisely those for whom the healthcare money is actually intended.”
The municipalities hope to prevent them from having to deal with healthcare fraud again with advance screening: entrepreneurs who forego money under the guise of arranging home care, taking in problem young people or providing services for a personal budget (PGB).
without care
After the ministry decided in 2015 that municipalities should take over the care tasks from the government, there was a great deal of work pressure. To prevent vulnerable people from being without care for too long, many municipalities decided to first contract care providers and only then screen them extensively.
That often went well, but often it didn’t. “A lot of fraud is mainly due to the loss of good quality care. This means that unskilled staff are deployed, individual goals are not worked on and clients do not receive the correct number of hours of care,” the Association of Dutch Municipalities immediately stated in a research report. from 2015.
Drug trafficking and fraud
The Association of Directors of Social Services Divosa speaks about “care cowboys”. “This fraud is committed from a strong social network where legal professionals, such as accountants, are also active. Within this network, money is sometimes also made from other criminal activities, such as drug trafficking or other fraud,” said public administration expert and criminologist Edward van der Torre. the website from Divosa. “Rogue healthcare providers maintain good relationships in the underworld and the upper world.”
It is no coincidence that the municipalities in Twente are taking the lead in tackling healthcare fraud. Disappeared at the Almelose care agency Victorie in 2018 tons of subsidies that were actually intended for the care of problem young people. An investigation by the social police showed that the director had used health care money to please clients, including with a Louis Vuitton bag. She would even have paid for a breast augmentation. She also visited a casino hundreds of times, possibly with health care money.
9.5 tons search
A little further, in Rijssen, care agency BiOns is accused of “playing the bench”. Nearly 9.5 tons of healthcare money has been lost there because it is said to have been shifted back and forth between BiOns and eight affiliated companies. The District Court of Overijssel stated: last week It has been established that around BiOns there is “a less transparent structure of affiliated companies and mutual money flows of a considerable size”. The court does not rule out “that health care funds have been withdrawn from the company for the benefit of third parties and/or the director.”
The case was striking, because the same driver was spring 2020 was still ordered to pay 910,000 euros in pension contributions, which she had not paid at an earlier stage, to the PFZW pension fund.
Dishonest healthcare providers
BiOns had just gone to court because the municipalities of Almelo and Hof van Twente had excluded the care agency from a new tender round and therefore did not want to offer a contract in advance. The court ruled in favor of the two municipalities. They “may set requirements with regard to care organizations”, the verdict reads, in order to protect vulnerable clients in particular.
If it is up to the joint municipalities, the Twente approach to healthcare fraud will serve as an example for the rest of the Netherlands in the future. Together with the Hart van Brabant region, the municipalities of Twente hope to qualify for the status of a national Living Lab for Care Fraud, a project for which the Ministry of Health, Welfare and Sport has a subsidy of more than 1 million euros available.
–