Wed, Dec 30, 2009 - Page 2 News List

Doctors admit defrauding insurance firms

STAFF WRITER, WITH CNA

Three doctors who have admitted to colluding with patients in defrauding some NT$80 million (US$2.5 million) from insurance companies could have their licenses revoked and be expelled from the profession, medical officials said yesterday.

Yang Chao-jan (楊超然), a physician with the Department of Health’s (DOH) Keelung Hospital, Lai Teh-hsing (賴德興), a surgeon with Yee Zen General Hosptial in Taoyuan County, and Wu Kuo-­ching (吳國精), a surgeon with St Joseph’s Hospital in Yunlin County, have been indicted by the Taoyuan District Prosecutors’ Office for fraud, along with seven others who acted as patients, DOH Minister Yaung Chih-liang (楊志良) said.

More medical workers are under investigation in the same fraud case, which involves more than 10 healthcare institutions and could end up being the largest medical scandal in Taiwan’s history, Yaung told a news conference yesterday.

The doctors are suspected of colluding with a ring headed by a man they identified as Fu Chien-sen (傅建森), who has since 2003 allegedly orchestrated fake medical treatment records with doctored diagnoses and surgery reports to claim cancer payments from life insurance companies, prosecutors said.

“The trick was using fake diagnoses and surgery reports as well as samples stolen from cancer patients to make the fraudulent insurance claims,” Yaung said.

For example, Yaung said, Fu underwent hemorrhoid surgery, but filed claims for reimbursement of cancer treatments that included certificates showing he had an operation and received chemotherapy for rectal cancer.

Shih Chung-liang (石崇良), director of the DOH Bureau of Medical Affairs, said the three doctors and seven patients defrauded between NT$60 million and NT$80 million from insurance companies.

Other individuals still under investigation, including four doctors, may have defrauded another NT$100 million from insurers.

The Keelung Hospital has given Yang two major demerits and relieved him of his duties, and the DOH has urged Yee Zen General Hospital and St Joseph’s Hospital to deal with Lai and Wu accordingly, Shih said.

Both Taiwan Medical Association chairman Lee Ming-ping (李明濱) and Taiwan Hospital Association chairman Wu Teh-lang (吳德朗) expressed support for the DOH’s decision to have the three doctors’ licenses revoked.

“It means that the three will not be able to practice their profession for the rest of their lives,” Shih said.

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