With the help of IDIKA’s technology and new control systems, recent virtual prescriptions have come to light, with the detection of at least 100 cases of overprescription to the detriment of EOPYY, while controls for virtual prescriptions and diagnostic tests will be extended by a period of 10 years.
At IDIKA, new control systems are now in operation and offensive behaviors are now easier to detect. Only in the eighth month of 2024 will the specific doctors that have recently been revealed prescribed 250 to 422 different pharmaceutical preparations per patient, with total quantities ranging from 250 to 1,630 pieces and millions of euros in losses to EOPYY.
According to EOPYY administrator Theano Karpodini, “accounts will be made so that the Greek public can recover lost money, while pharmacists involved in excessive prescriptions have been banned from filling prescriptions for 6 to 12 months. Recently, the prescriptions of five doctors were stopped due to violations of correct prescription, while sanctions of more than 2,500,000 euros were imposed and new cases are being processed.
Furthermore, the Organization requested the assistance of the Financial Police to investigate cases with strong indications of fraud against EOPYY.
What is done today in terms of diagnostic tests is a false execution, says Ms. Karpodini. Specifically, “EOPYY retroactively removes so-called PACs from diagnostic center machines. It is a digital system that diagnostic centers and laboratories are required to maintain, archiving images that essentially prove whether a test was performed. At the same time, referrals prescribed by doctors can be compared with the results of an examination. Regarding the prescription of diagnostic tests, informative notes are sent monthly to 34 thousand doctors”, says the Director of EOPYY.
Ms. Karpodini emphasizes that there are ongoing audits that focus on specific prescribing models. In collaboration with IDIKA, control is also carried out in real time.
At the same time, as part of the digital transformation, EOPYY has introduced an integrated SAP Financial Management and Compensation Information System (ERP), while modern techniques such as machine learning and business intelligence will be applied for data processing.
The insured’s EOPYY file is updated and the information is sent to HIDIKA so that it can be removed from its registry. There is provision for cleaning the patient’s medical records so that they do not have problems with the prescription and there is no wrong medical diagnosis in the future.
Source: AMPE