HMO fraud prompts Itau to fire 80 employees – News

Itai fired 80 employees this week for improper use of the Medicare plan. According to the bank, the workers submitted fraudulent requests to recover the costs of consulting and other procedures.

The operator had already warned of Increased suspicion of fraud, which has recently prompted Itau to step up instructions regarding illegal practices and scams related to the use of Medicaid. Employees have been instructed not to share their ID card, login or password for digital channels.

The bank also instructed them not to accept modifications for the purpose of treatment, examinations and procedures, especially when the purpose of the service is aesthetic and among those not covered by the health fund.

Health insurance and health plan companies have increased monitoring of user misconduct, in an effort to reduce harm from fraud, which is increasingly common. This topic prompted the creation, last year, of a specific department in FenaSaúde (National Federation for Complementary Health), an entity representing operators, to identify the most common frauds applied against companies.

In the past 15th, the union launched a program Health without fraudwhich provides videos, brochures, and other materials with guidance on the proper use of health plans.