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Brazilian health plan providers saw 27.8bn reais (US$6.8bn) worth of fraud and waste last year, according to a study.
Elaborated by the supplementary health studies institute (IESS), the study shows the plan providers spent a total of 145bn reais on health procedures in 2017.
"The 27.8bn reais in fraud and waste expenses represent 19.1% of this total, compromising service quality, the finances of the sector and burdening the contractors of the health plans," said IESS.
Some 15bn reais were linked to fraud with the rest to procedures considered unnecessary.
Brazil's health plan providers have come under intense fire in recent years due to consecutive annual price increases that have been above inflation - with the health industry arguing that costs have increased faster than inflation due to factors such as fraud and waste.