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Legislator says hospitals are defrauding patients

Unscrupulous medical providers are defrauding patients who undergo additional procedures during checkups, a Democratic Progressive Party (DPP) lawmaker alleged yesterday.

DPP Legislator Huang Sue-ying (黃淑英) said that although most medical services are covered by the National Health Insurance (NHI) system, some people choose to pay for more frequent checkups themselves.

Additional procedures such as biopsies that might be deemed necessary during the course of these checkups are covered by the NHI. Yet hospitals are charging patients for these procedures and seeking reimbursment from the Bureau of National Health Insurance (BNHI), Huang said.

The lawmaker said she had received complaints from a number of constituents who said their medical receipts did not make sense.

"Be very suspicious if the hospital wants to swipe your NHI card after you have paid for a procedure," she said.

In response, Sheen Mao-ting (沈茂庭), general manager of the Department of Medical Affairs under the BNHI, said the BNHI viewed "double charging" in a serious light. Previously, those caught red-handed were made to pay back the funds they had obtained improperly but were not punished because they argued that the BNHI had not made it clear that hospitals were not allowed to charge both the BHNI and the patient for the same procedure.

"We have made it very clear to all medical care providers that double charging will no longer be tolerated. It will be treated just as seriously as any other scheme used to defraud the BNHI," Sheen said.

Sheen said a strongly worded letter had been sent to hospitals and clinics clarifying the BNHI's policy.

"It is something that should have been self-evident," Sheen said.

Sheen said the rule would be strictly enforced and that providers found cheating could have their licenses suspended. Criminal charges could be brought against repeat offenders, he said.

Sheen advised patients to protect their rights by refusing to pay for additional charges beyond the fee they had agreed upon for their checkup.

Double-charging is just one of the ways the BNHI is defrauded by unscrupulous medical providers, people present at the press conference claimed.

"It is very easy for hospitals to get away with padding the bill because most patients do not properly scrutinize their hospital receipts," said Sun Yu-lian (孫友聯), the head of the BNHI Supervision Alliance. "Sometimes the NHI will be billed for `medication costs' even though the patient received no drugs."

"The only way we can do away with this kind of bad behavior is to impose serious penalties on the small percentage of offenders we do catch," Sun said.
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