Iceland’s health insurance agency ends investigations into Klíníkin over alleged overbilling

Iceland’s health insurance agency, Sjúkratryggingar Íslands, has discontinued investigations concerning alleged overbilling by the private healthcare provider, Klíníkin. The inquiries were initiated to scrutinize charges submitted by Klíníkin for services that the Icelandic government had financed in the past years.

This decision comes after allegations surfaced regarding three doctors from Klíníkin, who were suspected of overbilling the state by significant amounts, totaling tens of millions of Icelandic krónur, from 2022 to 2023.

Klíníkin, located in Reykjavík, offers various medical services, including joint replacement surgeries and procedures for obesity and endometriosis. In 2022, the clinic reported operating revenues of 2.6 billion krónur, with profits exceeding 200 million. The clinic has drawn considerable public attention, particularly after entering a cost-sharing agreement with Sjúkratryggingar Íslands for joint replacement surgeries.

In August, Klíníkin held its annual meeting, during which Eyjólfur Árni Rafnsson was appointed chairman of the board. He emphasized the need for the clinic to evolve its services in line with the country’s healthcare demands.

The investigations included scrutiny over claims for consultations that were billed as lasting 60 minutes, while actual sessions were only 30 minutes long. Additionally, it was found that those consultations might have been conducted by non-medically trained individuals, casting further doubt on the billing practices.

Despite multiple inquiries from the media, Sjúkratryggingar Íslands has not responded regarding the status of these investigations or their findings. Meanwhile, an overarching audit into the agency is currently ongoing, following administrative changes aimed at improving oversight of public healthcare services.