Dental Network Executives Accused of Insurance Fraud Scandal
In a shocking turn of events, three executives of the Nobel Health dental network, along with a pharmacist and others, are under formal investigation for a multi-million euro fraud case targeting the French Health Insurance. This case, however, is not related to the Nobel Santé dental network, as previously reported.
The accusations centre around an alleged fraud totalling around ten million euros. The investigations are being led by the Juridiction nationale de lutte contre la criminalité organisée (Junalco) of the Paris judicial court, with the Assurance maladie filing 12 complaints, asserting a loss of 3.4 million euros [1].
The executives were presented to the justice system following a series of arrests and searches. Two major searches were conducted, one in January 2024 and another recently, leading to significant bank seizures from the parent companies and contractors involved [1].
The Assurance maladie collaborated with the Office central de lutte contre la traite des êtres humains et les infractions liées aux migrations illicites (OCLTI) and reported discovering "practices frauduleuses et récurrentes" during the investigations [1]. As a result, the Health Insurance has taken action by deconventionning ten centres from the network in April 2024 [1].
The fraud is suspected to have been carried out through the use of fictitious invoices, multiple or inconsistent billings, non-compliance with good practice references, and deliberate destruction of healthy teeth. Interestingly, these centres were often set up in "medical deserts".
The charges, pronounced after custody, are part of an investigation opened in April for fraud and aggravated money laundering, in an organized gang [2]. Two of the executives, founders of an accounting expertise company, were remanded in custody on July 4, 2023. Another executive, Yoni S., 44, hopes to obtain judicial control and claimed that he is disabled at 80% and suffers from Guillain-Barré syndrome and Crohn's disease [2].
The case began in 2020 with a first complaint targeting billing of fictitious acts or modification of the nomenclature of acts [3]. Observed flow of 16,927,000 euros to various providers from eleven centres further supports the allegations [3].
It is important to note that Dan L., one of the executives, has numerous convictions on his criminal record, including abuse of trust, bankruptcy, and illegal exercise of the real estate agent profession, but these convictions are over twenty years old [2]. The other two individuals placed under formal investigation are a dental centre operational director and a pharmacist, who is Yoni S.'s brother [2].
The wives of the two executives are expected to be presented to the justice system in the fall [2]. The total damage, estimated at around 5 million euros over several years, is still being calculated [2].
Sources: [1] Le Figaro [2] Le Parisien [3] Agence France-Presse (various reports in 2023)
Science plays a crucial role in uncovering the fraudulent practices in the medical-conditions sector, as investigations into the Nobel Health dental network unveil repeated fraudulent practices such as issuing fake invoices and modifying nomenclature of acts. In the realm of health-and-wellness, the preventive measures and regulations enforced by authorities help protect the general public from similar financial scams.
