RIZIV, Belgium’s Social Security Agency, has been aware of fraud by a home health nurse from Houthulst (West Flanders) since 2017. An inspection was carried out at that time and she was penalised social affairs minister Frank Vandenbroucke (Flemish socialist Vooruit) has confirmed. Yesterday, it emerged that home nurse, Stefanie Sander, may have submitted false invoices to the tune of several million euros. The RIZIV is aware of 193 other cases of social fraud.
Health insurance funds and social security agency knew about fraud by home health nurse
Colin Clapson
Published:
For years, the home nurse from Houthulst is said to have invoiced for non-existent services and charged excessive healthcare costs. During a house search, the public prosecutor's office seized 17 luxury vehicles, luxury goods, real estate and cash. The health insurance funds are not surprised. ‘She was already on our radar,’ emphasises Paul Callewaert of the socialist health insurance fund Solidaris.
How long have the authorities been aware of fraud?
In 2017, the RIZIV carried out an audit on the home nurse that led to a sanction, the minister's office says.
Health insurance funds too carry out random checks and respond to warning signs. They visit patients at home to check whether the care listed on the invoices was actually provided. They also check whether the number of visits reported corresponds to what actually took place.
These checks brought the nurse to the attention of the health insurance funds. ‘We confronted her about it, but she ignored us,’ confirms Luc Van Gorp of the Christian health fund CM. The RIZIV confirms that Sander ignored demands to repay amounts. Ultimately, the RIZIV took the matter to court. The investigation there is now pending.
Should the checks be stricter?
The question now arises as to whether the woman could have been stopped earlier. Moreover, this is not the first time that social fraud on this scale has come to light. ‘In the past, we had a year in which we were able to recover 20 million euros,’ explains Callewaert.
The health insurance funds and the RIZIV have also noticed an increase in the number of fraud cases. The RIZIV currently has 193 cases on file, across all professional groups, not just home nurses.
Identity checks were introduced earlier to combat fraud. Nurses are required to scan the patient's identity card for certain healthcare procedures. Sander may have cheated in this regard as well, taking patients' identity cards home with her to scan them there.
What are the solutions?
Belgian health minister Frank Vandenbroucke has already announced various measures to better tackle social fraud in the future. These include that from 2026 a “billing cap” will apply: home nurses will only be able to submit invoices for a limited number of patients per day.