{"id":3088,"date":"2024-10-30T14:19:44","date_gmt":"2024-10-30T14:19:44","guid":{"rendered":"https:\/\/pragal-prinzenberg.de\/?p=3088"},"modified":"2026-07-15T10:34:01","modified_gmt":"2026-07-15T09:34:01","slug":"karlsruhe-higher-regional-court-billing-fraud","status":"publish","type":"post","link":"https:\/\/pragal-rechtsanwaelte.de\/en\/blog\/karlsruhe-higher-regional-court-billing-fraud\/","title":{"rendered":"Decision of the Karlsruhe Higher Regional Court on billing fraud"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">News on <a href=\"https:\/\/pragal-rechtsanwaelte.de\/en\/competencies\/criminal-defence\/commercial-criminal-law\/\">billing fraud<\/a> \u2013 Decision of the <a href=\"https:\/\/oberlandesgericht-karlsruhe.justiz-bw.de\/pb\/,Lde\/Startseite\" target=\"_blank\" rel=\"noreferrer noopener\">Higher Regional Court of Karlsruhe<\/a> on the scope of damages for quarterly collective declarations with partial \u2018fictitious services\u2019. In its decision of 10 April 2024, the Higher Regional Court of Karlsruhe made a fundamental and pleasingly restrictive decision on the scope of fraud damages in the case of quarterly collective medical declarations with partial \u2018fictitious services\u2019 (1 Ws 80\/24).<\/p>\n\n<p class=\"wp-block-paragraph\"><br\/>The case concerned a doctor who, as part of a quarterly collective declaration for around \u20ac1.2 million, had invoiced 37 coronavirus vaccinations totalling \u20ac804 that had not been provided in addition to a large number of other services that had been properly provided.<\/p>\n\n<p class=\"wp-block-paragraph\">Citing the strictly formal concept of damages and the \u2018guarantee function\u2019 of the quarterly joint declaration, the public prosecutor\u2019s office had assumed damages of around \u20ac 1.2 million and brought charges before the regional court. However, the regional court \u2018only\u2019 opened the main proceedings before the local court (court of lay assessors), as it had only assumed fraud damages of \u20ac 804. This decision was then confirmed by the Karlsruhe Higher Regional Court following an immediate appeal by the public prosecutor\u2019s office. This pleasingly restrictive decision is to be welcomed in view of the principle of guilt.   <\/p>\n\n<p class=\"wp-block-paragraph\">However, a closer look shows that the path to this result is somewhat more complicated than the Karlsruhe Higher Regional Court believes. This is because the OLG wishes to limit the scope of damages to the \u2018air services\u2019 in the amount of \u20ac 804 on the grounds that the doctor is ultimately entitled to a new determination of his fee in the amount of the services actually provided despite the invalidity of the quarterly collective declaration. In the context of the balancing of assets when determining damages, it should be noted that the emergence of the correct fee claim depends on an application and examination by the health insurance company, which can be quite critical and correspondingly lengthy. In addition, this is associated with a considerable estimation discretion.    <\/p>\n\n<p class=\"wp-block-paragraph\">Only at the end of this process is a new fee notice issued and the fee actually earned paid out. It is therefore at least \u2018bold\u2019 for the Higher Regional Court of Karlsruhe to speak of \u2018non-expired fee claims\u2019 of the doctor to justify the very low \u2018differential damages\u2019, which had not actually arisen at the time of the offence. If you would like to know more about this topic, please <a href=\"https:\/\/pragal-rechtsanwaelte.de\/en\/contact\/\">feel free to contact us<\/a> at any time. We would be very happy to answer any questions you may have.   <\/p>\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>News on billing fraud \u2013 Decision of the Higher Regional Court of Karlsruhe on the scope of damages for quarterly collective declarations with partial \u2018fictitious services\u2019. In its decision of 10 April 2024, the Higher Regional Court of Karlsruhe made a fundamental and pleasingly restrictive decision on the scope of fraud damages in the case &#8230; <a title=\"Decision of the Karlsruhe Higher Regional Court on billing fraud\" class=\"read-more\" href=\"https:\/\/pragal-rechtsanwaelte.de\/en\/blog\/karlsruhe-higher-regional-court-billing-fraud\/\" aria-label=\"Read more about Decision of the Karlsruhe Higher Regional Court on billing fraud\">Read more<\/a><\/p>\n","protected":false},"author":3,"featured_media":6028,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[17],"tags":[],"class_list":["post-3088","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-criminal-defence"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ 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