Investigation | 

Fraud squad arrest two doctors over alleged fake-patient scam that cost HSE €300k

Multiple claims for patient who had just one surgery visit ‘raise red flag’

Today at 06:49

Two doctors have been arrested by the garda fraud squad over an alleged ­conspiracy involving the overclaiming of more than €300,000 from the HSE.

The GPs, aged in their mid 40s and late 50s, are suspected of making more than €300,000 in false medical claims from the midlands surgery where they both worked over a two-year period.

Investigations established that the doctors allegedly submitted claims for two separate treatment types at the surgery that were more than 60 times the national average for this type of treatment.

“These matters certainly raised a red flag in the investigation – no other GP practice in the country had these type of claim figures,” said a source.

Detectives are also probing alleged instances where multiple claims were submitted for a patient who may have attended the surgery on only one occasion.

Both men were arrested by appointment on Tuesday morning on suspicion of an offence contrary to Section 71 of the Criminal Justice Act, 2006 and are being held in a garda station in the south.

The legislation is commonly used to detain gangland criminals. Gardaí are allowed to detain them for up to a week.

While there is no suspicion the GPs have any involvement in organised crime, they have been under investigation by the Garda National Economic Crime Bureau (GNECB) for more than two years.

Fraud-squad detectives began the investigation after receiving a complaint from the HSE, which carried out an audit into medical claims made by a prominent GP practice based in the midlands between 2017 and 2019.

The audit showed that more than €300,000 in false claims had ­allegedly been made from the surgery where both doctors worked at the time.

Detectives searched the surgery two years ago and seized a large number of files as well as computer devices that have been forensically analysed.

It is understood that the younger doctor is the more senior GP in the surgery.

“The audit carried out by the HSE showed that the claims that were submitted were far in excess of what would be expected in normal circumstances,” a senior source said.

Other arrests are expected in connection with the investigation, with the alleged fraud believed to have been “very organised” in nature.

The two doctors are expected to be released without charge before a detailed file is prepared for the Director of Public Prosecutions.

Gardaí announced details of the arrest yesterday. A statement said both men had been arrested as part of a GNECB investigation into “a complaint of alleged fraud against the Exchequer and the HSE between 2017 and 2019”.

In recent years the GNECB has been involved in a number of detailed investigations in which professional people including doctors have been arrested.

In a completely separate probe, a north Dublin-based doctor was arrested in April, 2021 by fraud squad detectives investigating around 200 insurance claims allegedly made using false identities and false utility bills, supported by false medical certificates.

The GNECB had been investigating the case for a year after complaints were made by the Personal Injuries Assessment Board and another agency.