Surprise inspections by the National Health Insurance Administration (NHIA) discovered 383 out of 803 medical institutions across the nation filed false reimbursement claims to the National Health Insurance system, an official said.
NHIA senior official Kao Shih-hao (高世豪) on Monday said that the funds have been recovered and the institutions involved have had their NHIA contracts revoked.
The inspections were conducted last year without the prior knowledge of the medical institutions’ operators, and of the 383 hospitals and clinics involved in fraud, 171 institutions have had their cases turned over to prosecutors, he said.
The amount collected through false claims was three times more than uncovered in 2014 and the highest ever in any single year, Kao said.
He attributed the discovery of more false claims last year to an upgraded computerized auditing system, manual checks of cases deemed suspicious by the computer system, and tip-offs from the public.
Among the cases uncovered were pharmacists writing prescriptions at one hospital even though they worked at another hospital, Kao said.
Through a joint investigation with prosecutors, many pharmacists were found to have leased their license to other medical institutions for between NT$8,000 and NT$10,000, while others filed false reimbursement claims with the NHIA, Kao said.
Taiwan Medical Clinics Association chairman Tseng Tzu-chan (曾梓展) said in defense of medical institutions that it is only a small minority that have been involved in fraud and said that the association would fully support prosecution of those found guilty.
Additional Reporting by Lin Hui-chin
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