Operation Cobra 2.0-A: 26 charged with $670,000 fraud against SeNaSa
A judge imposed preventive detention on eight defendants accused of defrauding the Dominican Republic's National Health Insurance by more than 40 million pesos. Thirteen defendants admitted the facts.
Coercive measures imposed on 26 defendants in major fraud case against public health insurance
The National Health Insurance of the Dominican Republic (SeNaSa) returned to the centre of national debate this week following the imposition of coercive measures on 26 defendants in the so-called Operation Cobra 2.0-A, according to almomento.net. Those charged face counts for alleged fraud against the state insurer valued at more than 40 million pesos, equivalent to around 670,000 dollars.
Judge Rigoberto Sena ordered preventive detention of 18 months for eight of the defendants. Nine others must comply with house arrest, whilst the remaining nine were subject to other measures, including financial guarantees, prohibition from leaving the country and periodic presentation to the authorities. The case file was declared to be of a complex nature.
The ruling came after several days of hearings in which the Public Prosecutor's Office presented hundreds of pieces of evidence. The prosecution also argued that 13 of the 26 defendants admitted the facts attributed to them.
A scheme for billing services not provided
The investigation began in mid-September with 37 raids carried out at various locations across Dominican territory. In the operations, doctors, healthcare service providers and other persons linked to the sector were arrested.
The Public Prosecutor's Office contends that those investigated would have used medical authorisations and documentation to bill SeNaSa for services that were never provided. The amount allegedly misappropriated exceeds 40 million pesos, although the investigation remains open and the figure could change as the judicial process progresses.
SeNaSa administers the main state-coverage regimes within the Dominican social security system, which gives the process particular repercussion in the country.
Connection to the first Operation Cobra
Operation Cobra 2.0-A is part of a broader case file that began with the first Operation Cobra. In that earlier phase, among others, the former executive director of SeNaSa Santiago Marcelo F. Hazim Albainy and other defendants were prosecuted.
The case keeps under scrutiny the internal control mechanisms used by the insurer to authorise, execute and bill for medical services within the public health system.
Source: Google News DO — Crime