Sat, Jul 12, 2003 - Page 4 News List

Health bureau defends payments

NO CORRUPTION In response to allegations of possible fraudulent claims submitted by hospitals, the Bureau of National Health Insurance yesterday explained its stance

CNA , TAIPEI

The Bureau of National Health Insurance yesterday denied that it has ever over reimbursed local hospitals or wasted any medical resources.

The bureau made its defense after a DPP lawmaker claimed that some hospitals might have submitted false expense reports and that the bureau's audit and control system was lax and flawed.

Legislator Tang Huo-sheng (湯火聖) quoted data from the Ministry of Audit as saying at a news conference earlier in the day that a patient stayed "1,015 days" in a hospital in 2000 alone.

"There are only 365 days in a year. How could one patient be hospitalized that many days that year?" Tang asked.

The ministry report also showed that a patient made 1,291 hospital visits in 2000 and that another patient cost the bureau NT$16.86 million that same year.

Tang said these outrageous figures indicate that the bureau ought to strengthen publicity and educate the general public not to abuse medical resources.

"The bureau should also tighten auditing to prevent medical facilities from reporting inflated medical expenses," Tang said.

In response, the bureau said that the patient whose annual medical bill exceeded NT$16 million suffered from Gaucher's disease.

The drug to treat this rare genetic disease is very expensive, the bureau said.

It pointed out that all of the top 10 medical spenders mentioned by Tang were patients with various rare diseases.

Treatment for those diseases are usually costly, the bureau said. The cumulative medical expenses of the bureau's top eight patients exceeded NT$100 million in 2000.

The bureau said one of the two patients Tang mentioned as having spent more than "1,000 days" in hospitals had been hospitalized since March 1997 for schizophrenia, but the hospital didn't apply for lump-sum reimbursements until 2000.

The other patient mentioned by Tang has also been hospitalized for many years, the bureau said, adding that the government's decision to offer full insurance coverage for rare diseases is a boon to patients even though the coverage has been a heavy burden for the bureau.

In related news, with the SARS outbreak having been contained, PFP Legislator Chin Huei-chu (秦慧珠) expressed reservations yesterday about the wisdom of reserving a military medical facility as a SARS-only hospital.

Chin called a news conference at the Legislative Yuan where she questioned whether it is necessary to designate the Armed Forces Sungshan Hospital in Taipei as a SARS-only hospital.

Sungshan hospital was the nation's first officially-designated SARS-only medical facility. However, Chin said, the hospital has only received 14 SARS patients.

"Sungshan has more than 530 staff members and 137 negative-pressure quarantine wards. Is it wise or reasonable to reserve the facility for SARS patients?" Chin asked.

She said residents in the vicinity of the hospital have launched a signature campaign to urge the government to allow Sungshan to resume its original outpatient and inpatient clinical services.

"I support the campaign to avoid waste of precious medical and manpower resources," Chin said.

In response, Center for Disease Control Deputy Director Shih Wen-yi (施文儀) said the center has come up with a blueprint for setting up several hospitals specializing in treating communicable diseases, including SARS.

"We need a comprehensive communicable diseases prevention and treatment system, not just a SARS service network. We ought to conduct an overall review. The center will call a meeting to discuss the issue next week," Shih said.

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