Tue, Jul 30, 2019 - Page 1 News List

Chinese spouse lent NHI card to cousin for treatment

NO PHOTOGRAPH:The cousin’s medical bills totaled about NT$900,000, and was the biggest single case of fraudulent use of an NHI card, the NHI director-general said

By Lee I-chia  /  Staff reporter

A Chinese woman married to a Taiwanese man was found to have illegally lent her National Health Insurance (NHI) card to her cousin so that she could undergo NHI-funded cancer treatment in Taiwan, the National Health Insurance Administration said yesterday.

The cousin, who was in Taiwan illegally, used the card to receive stomach cancer treatment from March 2016 until she died in November that year, NHI Director-General Lee Po-chang (李伯璋) said.

The patient used the card to consult a doctor, and to cover hospitalization and surgery costs at a medical center, which totaled about NT$900,000 (US$28,937 at the current exchange rate), he said.

It was the biggest single amount in any NHI card fraud case, and it was not revealed until the hospital was about to issue a death certificate in the cardholder’s name that she confessed to loaning the card to her cousin, Lee said.

The cardholder was tried and sentenced to four months in prison, suspended for two years. The agency last year also demanded compensation of NT$1.12 million from the woman, Lee said.

The agency has discovered 35 NHI card fraud cases since 2014, in which more than NT$1.75 million worth of medical resources were used illegally, Lee said. Nineteen of them were committed by foreigners, most of whom were unaccounted-for migrant workers, and 16 by Taiwanese, he said.

Most of the cases were reported by healthcare personnel, the National Immigration Agency or members of the public, he added.

Medical costs in NHI fraud cases can range from several hundred to tens of thousands of New Taiwan dollars, Lee said.

Many offenders face no prosecution at all or deferred prosecution due to the small amounts involved, he said, adding that the cases that were prosecuted might only be the tip of the iceberg.

The agency has instructed health facilities to ask for identification cards with photographs from people whose NHI cards do not have a photograph.

Under the National Health Insurance Act (全民健康保險法), the agency can refuse to reimburse medical expenses if a health facility fails to verify a patient’s identity and can impose a fine up to 20 times the expense if the facility knowingly accepts a person using someone else’s NHI card, agency official Tung Yu-yun (董玉芸) said.

A regulation that took effect in January last year requires those applying for or renewing NHI cards to provide a photo.

Additional reporting by CNA

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