Taipei, April 9 (CNA) Dozens of medical institutions and professionals in southern Taiwan were found of defrauding more than NT$70 million (US$2.09 million) from the National Health Insurance program in over 100,000 cases in an investigation conducted during the first three months of this year, a spokesman for the Tainan Public Prosecutors Office said Thursday.
Although almost all the cases occurred in Tainan and Kaohsiung cities, the spokesman said, they represent only "the tip of the iceberg" in the widespread problem of fraud against the insurance system by medical institutions in the country.
Those accused of being involved in the insurance fraud cases include the Department of Health (DOH) -governed Tainan Hospital Hsinhua Branch, 10 private clinics, five pharmaceutical stores and about 70 nursing homes, as well as two clinic owners, 19 medical doctors, seven pharmacists, and four medical service brokers, according to the spokesman.
The Tainan District Court granted a prosecutors' request to detain 12 suspects. Fourteen others have been released on bail, the spokesman added.
During raids of the medical institutions, investigators removed a batch of patient records and questioned 22 people, including nine physicians at the DOH Tainan Hospital, the first time a public hospital was suspected to have been involved in fraud, according to the spokesman.
The nine medical professionals, including three active executives and six former physicians at the hospital, were suspected of colluding with scores of local nursing homes to defraud the national health care program of NT$30 million between 2006 and 2008 by issuing a large number of chronic illness prescription refill slips, according to spokesman.
The nine doctors have been released on NT$800,000-NT$1 million bail after admitting to committing fraud, the spokesman said. They had claimed they were under pressure to reach their business targets set by the hospital to avoid being fired, the spokesman added.
However, the hospital issued a statement Thursday denying that it had pressed doctors to meet revenue objectives, adding that some of the accused were contracted doctors and were unlikely to be under work performance pressure.
Using fake prescriptions is a common fraud practice against the national health insurance system, the spokesman added.
Taiwan News
