During this period, nearly 50,000 tips regarding misconduct were received, leading to approximately 9,300 verified cases of fraud.

The largest area of loss, nearly 86 million euros, is attributed to fraudulent prescriptions for expensive medications, often filled far from the patients' actual residences.

The complexity of these fraud cases is increasing, often involving interconnected networks and multiple participants, which complicates investigations.

The GKV also calls for a dedicated study by the German government to investigate the extent of unreported fraud within the healthcare system.

Despite the significant losses, approximately 92 million euros have been successfully reclaimed through legal or extrajudicial means as a result of these investigations.

To combat this rising fraud, the GKV-Spitzenverband is advocating for legislative changes, including the use of artificial intelligence to analyze billing data across all insurance providers.

Martin Krasney, a board member of the GKV, emphasizes that these financial losses detract from essential medical and nursing care for the public.

Fraud in the healthcare sector in Germany has reached unprecedented levels, causing over 200 million euros in financial damage for statutory health insurance funds during 2022 and 2023.

Among the various fraudulent activities, the misuse of medications such as Ozempic and painkillers like Tilidin and Fentanyl has been highlighted, with criminals falsifying prescriptions to exploit the system.

Almost half of the fraud tips were related to nursing services, with over 62 million euros identified in fraudulent claims, although only 21 million euros were successfully recovered.

The GKV estimates that fraud and corruption may account for 5-10% of total healthcare spending in Germany, suggesting potential losses in the tens of billions.

Whistleblower protections are currently inadequate, with less than 20% of fraud reports originating from insiders, leaving many violations unreported.