Authorities probe fake hospital insurance claims

2020-12-17 12:10:01

Pharmacists work at a hospital in Enshi, Central China's Hubei province. [Photo/VCG] National healthcare authorities are investigating reports of healthcare insurance fraud in Anhui province's Taihe county. The announcement was made by the National Healthcare Security Administration on Wednesday, two days after Beijing News reported that four hospitals in the county had forged records to make fraudulent insurance claims. The unlawful practices allegedly happened at one public hospital and three private ones, and included providing fake hospitalization documents for patients who did not need treatment so that the government would pay for their hospital stays. In one case, an elderly man surnamed Wang was hospitalized by the public Taihe No 5 People's Hospital three days after he was discharged by the private Dongfang Hospital. Wang told Beijing News that he had been hospitalized nine times this year. "I lived in hospitals for almost three months. I would go to whichever one promised me free hospitalization," he said. But hospitalization documents claimed the patients had all received treatment. In another case, a fake patient whose name was not given in the report, paid 500 yuan ($76) to Dongfang Hospital before being hospitalized. Six days later, hospitalization documents show that the person had spent 1,817 yuan, of which 1,318 yuan had been covered by healthcare insurance. The cashier then returned 300 yuan to the person, which means he or she spent just 200 to live in the hospital for almost a week, with meals included. Some other people were willing to cooperate with the hospitals based on the promise of free physical examinations, Beijing News reported. The report found that intermediary agents served as bridges between the hospitals and fake patients. In some cases, the agents would pick up the people from their homes and later arrange for vehicles to take them back. The administration said it had told the provincial healthcare authorities to sternly punish any wrongdoing to protect the security of healthcare funds. The Communist Party of China's Anhui Commission for Discipline Inspection and the Anhui Provincial Supervisory Commission announced on Tuesday that a team of investigators had arrived in the county for further investigation. Fraudulent healthcare insurance claims were also found in a public hospital in Hefei, the provincial capital, by Xinhua News Agency in 2018. Leaders of the hospital were removed from their positions, while eight medical personnel, including doctors and nurses, were banned from practicing medicine for seven months. Two of them were also prohibited indefinitely from entering the hospital. Wang Xiaodong contributed to this story.