Medical fraud, a deception that can be committed in a variety of ways and for different reasons – often for financial gain – has been widely reported on, and anyone seeking healthcare could unknowingly fall victim to it.
Understood by RTL Today as the intentional deception or misrepresentation of information in the provision/billing/documentation of healthcare services to obtain a benefit, holidaymakers – often visiting a place they are not familiar with and trying to get by in a language they have limited knowledge of – can unwittingly become victims of medical fraud if they are not adequately informed of how to access medical treatment at their destination, and the options available to them.
In the midst of a medical emergency, treatment could be sought, for example, at a private hospital where substantial bills are incurred, when healthcare could be available at a public hospital at significantly lower cost, depending on the situation. But often, in the excitement of preparing for a holiday, looking up the options for what to do in a medical emergency does not feature on the to-do list.
One Luxembourg family believes they experienced something similar to that described above, during a recent holiday in Europe, and they contacted RTL Today to share their experience.
David and Julia* travelled to Mallorca with their two-and-a-half-year-old son Harry on 18 May, for what they hoped would be a relaxing family holiday, providing a break from the busyness of their daily lives in Luxembourg. But shortly after arriving, Harry's mild cough worsened rapidly and he began struggling to breathe.
Concerned, they asked their hotel to arrange an appointment with a physician. A doctor from a private clinic visited twice, prescribed medication, charged a fee, and, when Harry's condition deteriorated further, recommended calling an ambulance.
According to the family, the doctor assured them that they would not have to pay anything further and the family explained to us that that they were unaware that they were being taken to a private hospital when a public hospital offering the same care was available to them for free.
On arrival at the hospital, the doctor there explained that the medication that had been prescribed was not appropriate for their son's weight, and that Harry would need to spend the night in hospital to be monitored.
Despite this, the family told us that no member of staff proactively came into Harry's room during the night to check on him, undermining the very reason for him being in hospital. Julia was asked if she had brought paracetamol with her, and was asked to take Harry's temperature herself.
In addition to this, suitable paediatric equipment was not immediately available, the prescribed antibiotic had to be sourced from an external pharmacy, and the hospital retained their passports until discharge without explanation.
RTL Today could not independently verify these allegations.
The next morning, the paediatrician who reviewed Harry told the family, clearly and in English, that if they were to stay until the afternoon, the doctor would write in Harry's report that they were there for 24 hours to make sure that their insurance covered everything.
According to the family, they understood the doctor's comments to mean that Harry's medical record could state he had remained in hospital for 24 hours despite being medically fit to leave earlier.
The family say they refused and requested immediate discharge. They also asked to speak with the hospital director, a request that was denied. They were instead directed to a different team, who also encouraged them to stay longer than needed to ensure their insurance would cover the costs.
They had to wait nearly two hours, make multiple demands, and physically station themselves at reception to not be ignored, before finally receiving their documents, passports, and Harry’s prescription.
They have since lodged a complaint with the Balearic Medical Regulatory Body in Mallorca and informed Luxair Tours, with whom they were travelling, of their experience.
The regulatory body responded to David and Julia's complaint in a letter, which RTL Today has seen, and have dismissed the complaint, though the family has a right to appeal this decision.
RTL Today contacted Luxair to ask what they would advise a customer travelling on a Luxair Tours package, who requires medical assistance during their trip and during/after the process realises that they are the victim of medical fraud, to do.
Luxair advised that "if medical assistance is required, customers are strongly advised to contact their local Luxairtours contact as early as possible. They can help direct customers towards official doctors, clinics or hospitals at destination."
"If a customer suspects medical fraud, the first recommendation is to keep all relevant documents, including invoices, prescriptions, medical reports and payment receipts, and to contact Luxairtours immediately. Support can then be provided by helping to identify relevant local contacts and assisting with practical coordination at destination."
Looking back, David and Julia say they hope their experience encourages other travellers to ask whether they are being referred to a public or private hospital, where circumstances allow, and to familiarise themselves with the local healthcare system before travelling.
They also recommend documenting any concerns, checking travel insurance policies ahead of time, and reporting suspected misconduct to the relevant authorities.
RTL Today contacted the Ministry of Health and Social Security (M3S) and the CNS to ask what practical advice they would give to Luxembourg residents in the situation where they believe they may be victims of medical fraud. They responded that "the most important thing is to remain vigilant and document everything", while also providing an extensive list of useful tips.
It is also worth knowing how the EHIC can help abroad. As the European Commission's website explains, the EHIC is a "free card that allows you to access medically necessary, state-provided healthcare while you are temporarily staying in any of the 27 EU countries, as well as Iceland, Liechtenstein, Norway, Switzerland, or the United Kingdom."
Luxembourg's National Health Fund (CNS) has lots of helpful information on topics such as the validity of the EHIC card, how to obtain one, and what to do if you lose your card or it is stolen.
* The family's names have been changed for reasons of anonymity.
