Belgium to Implement Strict New Home Nursing Fraud Rules in 2026 Following Multimillion-Euro Case

New Regulations to Combat Home Nursing Fraud

Belgium is poised to implement stringent new regulations in 2026 aimed at curbing social fraud within the home nursing sector. The measures, announced by Federal Health Minister Frank Vandenbroucke, include a significant change: a daily limit on the number of visits a home nurse can bill for. This move comes in the wake of a substantial fraud case that recently surfaced in West Flanders.

The new rules are a direct response to a major fraud investigation in the municipality of Houthulst, where a self-employed home nurse is suspected of claiming reimbursement for fictitious services from health insurers. Investigators involved in the case seized 17 luxury vehicles, real estate, luxury goods, and cash, with the falsely claimed amounts believed to be in the millions of euros.

Details of the Fraud Case and New Measures

According to Minister Vandenbroucke, the nurse at the center of the Houthulst investigation allegedly claimed to visit up to 90 patients a day, sometimes seeing the same patient multiple times. This figure is considered highly improbable, as an average home nurse typically conducts around 15 to 20 visits per day.

Beyond the daily visit cap, the upcoming anti-fraud measures will introduce several other mechanisms to enhance oversight and accountability:

• Authorities will gain the power to temporarily suspend a provider's NIHDI (National Institute for Health and Disability Insurance) number, effectively preventing them from billing health insurers.
• Home nurses will be mandated to read a patient's ID card at every visit to ensure proper identification and service delivery.
• Patients will receive a detailed overview of all care services billed in their name, allowing them to verify the accuracy of claims.
• Health insurers will face increased accountability, with targets to detect €25 million in fraudulent activity next year, escalating to €100 million by 2029. Failure to meet these targets will result in deductions from their allocated allowances.

Industry Reaction and Broader Context

While the government emphasizes the necessity of these measures, the Flemish professional association for self-employed nurses (VBZV) has voiced opposition to the proposed daily patient cap. The association argues that such a limit is overly restrictive and 'may threaten the viability of independent practices'. Instead, the VBZV advocates for 'targeted, proportional and justified' inspections rather than broad restrictions.

The Houthulst case is not an isolated incident in Belgium's ongoing battle against healthcare fraud. In the first nine months of the current year, administrative tribunals of the Medical Evaluation and Inspection Service (DGEC) adjudicated 44 cases, with 39 leading to demands for repayment and/or fines. This resulted in €4.8 million in undue payments being reclaimed and an additional €4.5 million in fines imposed across various healthcare professions.