The irregularities were reported by the patients themselves after checking their treatment histories in the so-called ZIP, the Integrated Patient Information system, where people can find out how much the fund paid doctors for their treatment or diagnostic procedures. The defendant is 53-year-old Dorota R., who provided medical services at two offices in Legnica under a contract for the reimbursement of services signed by a Non-Public Healthcare Institution.

On August 29, 2014, the director of the Lower Silesian Provincial Branch of the NFZ in Wrocław reported the crime to the Legnica prosecutor’s office. The report stated that four of the defendant’s patients had disputed having received medical services from the doctor over the preceding years. The investigation established that these women, as well as four additional people, had in fact been under the care of other doctors at other facilities during that period. This was verified by examining their medical records.

Dorota R. was charged with falsely certifying in patients’ medical records, 64 times between 2008 and 2014, that medical services had been performed when they had not actually been provided, in relation to eight patients, and with using this documentation to fraudulently obtain a total of approximately PLN 3,900 from the National Health Fund. Dorota R. initially denied committing the crime and explained that accidental errors might have occurred.

However, during a subsequent questioning, following the charges being supplemented, R. admitted to all the acts alleged against her and expressed remorse. She refused to provide any further explanation. At the same time, she applied to be convicted without a trial.

The prosecutor, assessing that the circumstances of the crime were not in doubt and that the defendant’s conduct showed that the objectives of the proceedings would be achieved without a trial, asked the court to issue a sentence agreed with the defendant: a sentence of nine months’ imprisonment, suspended for two years; a PLN 5,000 fine; and an order requiring her to repair part of the damage by paying PLN 1,790 to the Lower Silesian Provincial Branch of the NFZ in Wrocław.

The case will be handled by the District Court in Legnica.

District Prosecutor’s Office in Legnica/ii