Germany’s DAK-Gesundheit health insurance fund recorded around 2,300 new suspected cases of billing fraud in 2024 and 2025. This was 30 percent more than in the previous reporting period, the health insurer said in Hamburg on Friday. Overall, DAK investigated nearly 4,900 existing and new cases, 20 percent more than in the previous reporting periods. The resulting financial damage amounted to €15.6 million.
The area most affected was pharmaceuticals and medical supplies, accounting for €5.5 million in damage. The main cause was forged prescriptions for high-priced cancer drugs and weight-loss injections. Between April 2024 and November 2025 alone, DAK recorded around 1,000 forged prescriptions, resulting in approximately €1.1 million in losses.
Almost half of all fraud cases were attributed to the care sector. The resulting damage amounted to €3.6 million. More than €2 million of this amount involved home nursing care, around €1 million concerned outpatient intensive care, and more than €600,000 related to long-term care insurance.
The third-most affected area was transport costs, where billing fraud caused €1.8 million in damage, DAK said. In the medical aids sector, the damage amounted to €1.6 million, while the therapeutic services sector recorded losses of €800,000. Around 23 percent of the completed suspected cases were ultimately proven to involve fraud.
The total damage was higher in the previous reporting period, at €17.6 million. DAK said that the overall high level of damage was again partly due to a small number of major cases involving losses of millions of euros. DAK was able to recover around €5.9 million during the previous reporting period.
In view of the increasing number of fraud cases and organised crime, the health insurer called for improved legal conditions to combat such offences. The ongoing digitalisation of the healthcare sector is creating “more points of attack”, but it also offers “opportunities”, explained DAK specialist department head Dennis Zachert.
Artificial intelligence could “contribute both to the detection of fraud and to the prevention of cases of fraud”. To make use of this potential, a “secure and binding legal basis under data protection law” was needed, Zachert stressed.
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