Während die Bestechung und Bestechlichkeit von, in öffentlichen Krankenhäusern angestellten Ärzten, als Folge des „Herzklappenskandals“ und der darauf beruhenden Reform des Korruptionsstrafrechts bereits seit 1997 nach den §§ 331 ff. StGB strafbar sind, unterfielen niedergelassene Vertragsärzte auch nach der Rechtsprechung des Großen Strafsenats bis zum Inkrafttreten der §§ 299a ff. StGB am 04.06.2016 nicht den Korruptionsdelikten. Thematisch damit verbunden war und ist die Frage, ob Vorteilsgewährungspraktiken in diesem Bereich vom Tatbestand der Untreue erfasst sein könnten. Ihrer Beantwortung dient der erste Teil der Arbeit. Der zweite Teil fokussiert die Relevanz der Korruptionsvorschriften für das gewählte Arbeitsthema. Die Einbettung der Gesamtthematik in den Kontext der Korruptionsdelikte führt die Ausgangsbetrachtungen zur Untreue fort und ergänzt diese durch eine Bewertung nach den neuen Gesetzesregelungen. Das gewählte Arbeitsthema zeigt, wie wesentlich die Beschäftigung mit den relevanten Normen des Rechts der Gesetzlichen Krankenversicherung für die strafrechtlichen Bewertungen in diesem Bereich ist. Dies gilt umso mehr, wenn mit sozial- und beziehungsweise oder berufsrechtlichen Verstößen strafrechtliche Konsequenzen einhergehen und die fehlerhafte Anwendung der einschlägigen Rechtsnormen anderer Rechtsbereiche zwangsläufig auch zu falschen strafrechtlichen Schlussfolgerungen führt. Dieser Kritik sieht sich auch die Rechtsprechung des Bundesgerichtshofes zur sogenannten Vertragsarztuntreue ausgesetzt. Auch hier wurden die Besonderheiten des Sozialversicherungsrechts nicht mit der notwendigen Sorgfalt eruiert und stattdessen eine - seit mehreren Jahren - nicht mehr vertretene Rechtsprechung des Bundessozialgerichts zur Grundlage der strafrechtlichen Bewertungen gemacht. Dass dies weder den Anforderungen des Bundesverfassungsgerichts entspricht, noch mit den sozial- und strafrechtlichen Vorgaben vereinbar ist, zeigen die Ausführungen der Arbeit. In der Form eines kritischen Ausblicks werden abschließend, die Grenzen zulässiger verordnungsbezogener Vergütungen durch die Krankenkassen aufgezeigt und deren strafrechtliche Relevanz eingeordnet. Letzteres erfolgt am Beispiel eines Vertrags zur Förderung sog. biosimilarer Arzneimittel durch die Zahlung einer prozentualen Einsparbeteiligung als Gegenleistung für deren bevorzugte Verordnung. Die Konstellation verdeutlicht, dass auch die monetäre Einflussnahme der Krankenkassen auf das Verordnungsverhalten der Vertragsärzte strafrechtsrelevante Wirkung haben kann, wenn sie zu unberechtigten Wettbewerbsverzerrungen führt. / As a consequence of the so-called “heart valve scandal”, and the reform of the German criminal law on corruption that followed in the wake of the scandal, it has been a criminal offence under sections 331 et seqq. of the German Criminal Code [Strafgesetzbuch – StGB] since 1997 to give bribes to medical practitioners employed in public hospitals, or for such medical practitioners to take bribes. However, until sections 299a et seqq. StGB entered into force on 4 June 2016, acts committed by medical practitioners in private practices were not deemed to be corruption offences under the Criminal Code. This was also affirmed by the case-law of the Grand Criminal Panel of the German Federal Court of Justice [Großer Senat für Strafsachen]. A topic that has been repeatedly discussed in connection with the aforementioned issue is whether the practice of granting benefits in healthcare might constitute an offence of embezzlement. The first part of this dissertation provides an answer to that question. The second part focuses on the significance that corruption provisions have for the topic discussed herein. Following the initial analysis of the issue of embezzlement mentioned, this issue is expanded by a discussion of the overall topic in the context of corruption offences, supplemented by an assessment of the topic in the light of new legislation introduced. An analysis of the topic chosen for this dissertation shows how important it is to study the relevant legal provisions of the law on statutory health insurance in order to be able to carry out an assessment of the topic from the perspective of criminal law. This applies all the more so in cases where a breach of social law and/or the law of professional rules and regulations might have consequences under criminal law, and the faulty application of applicable legal rules from legal areas outside criminal law would inevitably also lead to wrong conclusions being drawn on the basis of criminal law. The case-law of the German Federal Court of Justice [Bundesgerichtshof] on so-called “embezzlement by medical practitioners in private practice” [Vertragsarztuntreue] has been criticised in this respect. The Federal Court of Justice did not take account of the specifics of German social security law in a sufficiently diligent manner, and instead used outdated case-law of the German Federal Social Court [Bundessozialgericht] as a basis for its criminal-law assessment—precedents that were overruled by the Federal Social Court itself many years ago. This dissertation shows that this does not meet the requirements of the German Federal Constitutional Court [Bundesverfassungsgericht] and that such an approach is incompatible with requirements under social and criminal law. Finally, the limits of admissible prescription-related remuneration by health insurances are discussed and demonstrated from a critical, future-oriented perspective, together with the significance these limits have from a criminal law perspective. The significance of such limits is discussed using as an example a selective-agreement model designed to promote so-called “biosimilar medicines” by paying medical practitioners a percentage of the savings achieved in return for practitioners prescribing such medicines rather than more expensive ones. The circumstances discussed illustrate that the monetary influence that health insurances exert over the way in which medical practitioners in private practice prescribe such things as medicines may have consequences under criminal law if such influence may lead to competition being distorted. In the light of the above, health insurances should not be provided with additional criminal-law-related exceptional provisions that would enable them to exert further influence over the neutrality of decision-making in the area of medical prescriptions.

This study was conducted as a result of the various media reports, various law enforcement investigation reports, Public Service Commission, reports of the Auditor General South Africa and the Public Protector South Africa on corruption and the various forms in which corruption manifests itself in the City of Tshwane Metropolitan Municipality and the effectiveness of the various law enforcement agencies and the government in tackling the scourge of corruption in public and private institutions. While South Africa has various anti-corruption strategies, they all seem to be ineffective and have thus far not achieved their desired results. A qualitative research approach was used to investigate this problem. A thorough literature study and documentary analysis was used to gather all the relevant data related to this topic. It has been found that the most common manifestations of corruption that take place in the South African public service are fraud, bribery, extortion, nepotism, conflict of interest, cronyism, favouritism, theft, graft, embezzlement and abuse of power. Other forms of corruption that raise concern are, for example, influence-peddling, insider trading/abuse of privileged information, bid-rigging and kickbacks. South Africa has, on the other hand, seven anti-corruption institutions and seventeen pieces of legislation which are intended to combat corruption in the public and private sector. These pieces of legislation give South African law enforcement and investigators in the public and private sectors a clear mandate with a view to investigating the high levels of corruption. It is the submission of the Public Service Commission (2011:vi) that corruption has become a global concern that seriously hampers development in any country and diverts its resources from where they are needed the most. The most unfortunate truth and reality about corruption is that the poor suffer the most. / Criminology and Security Science / M. Tech. (Forensic Investigation)

This study was conducted as a result of the various media reports, various law enforcement investigation reports, Public Service Commission, reports of the Auditor General South Africa and the Public Protector South Africa on corruption and the various forms in which corruption manifests itself in the City of Tshwane Metropolitan Municipality and the effectiveness of the various law enforcement agencies and the government in tackling the scourge of corruption in public and private institutions. While South Africa has various anti-corruption strategies, they all seem to be ineffective and have thus far not achieved their desired results. A qualitative research approach was used to investigate this problem. A thorough literature study and documentary analysis was used to gather all the relevant data related to this topic. It has been found that the most common manifestations of corruption that take place in the South African public service are fraud, bribery, extortion, nepotism, conflict of interest, cronyism, favouritism, theft, graft, embezzlement and abuse of power. Other forms of corruption that raise concern are, for example, influence-peddling, insider trading/abuse of privileged information, bid-rigging and kickbacks. South Africa has, on the other hand, seven anti-corruption institutions and seventeen pieces of legislation which are intended to combat corruption in the public and private sector. These pieces of legislation give South African law enforcement and investigators in the public and private sectors a clear mandate with a view to investigating the high levels of corruption. It is the submission of the Public Service Commission (2011:vi) that corruption has become a global concern that seriously hampers development in any country and diverts its resources from where they are needed the most. The most unfortunate truth and reality about corruption is that the poor suffer the most. / Criminology and Security Science / M. Tech. (Forensic Investigation)