WILLEMSTAD - A general practitioner on Bandabou has been ordered by the court to repay 57,632 guilders to the Social Insurance Bank (SVB) for unjustified claims related to home and emergency visits. The amount was determined on appeal, following a previous ruling in which the initial repayment request of 63,635 guilders was reduced.
In 2022, the SVB discovered that the doctor, who has run his own practice for 40 years, was claiming significantly more home and emergency visits than other colleagues in Bandabou. A performance audit revealed that nearly half of the claimed visits did not meet the necessary requirements. The doctor argued that these visits were essential to monitor the health of his patients and prevent the need for more expensive medical care.
However, the court ruled that the doctor did not adhere to the guidelines outlined in a 2018 circular, which states that a home visit should only be carried out if there is a prior medical necessity. The doctor's argument that he acted in the best interest of his patients was deemed insufficient to justify the claims.
The ruling affirms that the SVB has the right to reclaim improperly declared amounts. This serves as a warning to other healthcare providers to strictly follow the guidelines when claiming medical services.