Capping a five-month investigation, the Taipei District Prosecutors’ Office yesterday charged 39 people with medical insurance fraud.
Neurologist Lin Chun-chieh (林俊杰) allegedly colluded with a group of insurance brokers to make fraudulent National Health Insurance (NHI) claims totaling about NT$20 million (US$661,923), the prosecutors said.
They charged Lin and the other suspects with fraud, forgery of documents, and other offenses under the Criminal Code.
Lin is the chief of the Peripheral Neurology Division at the Tri-Service General Hospital in Taipei, a military hospital and medical training center administered by the Ministry of National Defense.
The prosecutors said they have identified Chang Ming-yuan (張明源) as the brokers’ ringleader, who helped Lin collude with more than 200 people to claim false NHI benefits for more than two years.
Lin collected NT$15,000 for each false claim, they said.
The prosecutors said they have dropped all charges against 49 people in exchange for their cooperation in the probe and returning falsely claimed money.
Another 165 people are still being investigated, Taipei Deputy Chief Prosecutor Chang Chieh-chin (張介欽) said.
“The indicted brokers worked with people seeking treatment at hospitals to help claim NHI benefits, for which they charged a fee. The brokers contrived with patients by bringing them to be diagnosed by Lin,” Chang said.
“The patients were coached to walk slowly and act as if they had physically debilitating conditions. Lin was part of the fraud. He altered the readings from the test instruments and wrote down medical conditions that result in disabilities impeding work,” Chang said.
Investigators found that the “patients,” with the help of the brokers and Lin’s false diagnoses, claimed NHI disability benefits, the prosecutors said.
The brokers kept 30 percent of the payouts and Lin collected about NT$5 million in total, they said.
Prosecutors requested a heavy punishment against Lin.
“Lin, as chief neurologist at Tri-Service General Hospital, chose not to preserve his good reputation, but chose to dishonor his profession and violate medical ethics by colluding with brokers to produce deceitful diagnosis documents to falsely claim NHI benefits,” they said.
The alleged fraud was discovered when Bureau of Labor Insurance officials found an unusually high number of disability claims coming from patients diagnosed by Lin.
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