Fifty-three medical institutions have been found to be illegally “renting” pharmacist licenses, and the National Health Insurance Administration (NHIA) yesterday said it had canceled contracts with 16 of the facilities, and will seek to recover NT$30 million (US$976,700) in allegedly illegal reimbursements.
The agency in June launched a probe of 121 medical facilities nationwide that were suspected of renting pharmacist licenses, which would amount to healthcare fraud, NHIA irregularities mission team senior executive director Kao Shih-hao (高世豪) said.
“Fifty-three of the institutions inspected were found to have irregularities. Sixteen have had their contract with the National Health Insurance [NHI] program rescinded due to the severity of their wrongdoings, while 10 have had their contracts suspended for periods ranging from one month to three months, while 27 were given demerits,” Kao said.
A preliminary investigation into the 26 facilities whose contracts were either terminated or suspended found that they were using pharmacist licenses belonging to six public servants, eight university instructors or faculty members, and an employee of a state-owned company.
The 15 license holders will be blacklisted for a year and have been referred either to the government’s civil service ethics department or investigative agencies for further inquiries, Kao said.
There could be a number of reasons a medical institution would illegally rent a pharmacist license, such as to bypass a NHI regulation that reduces reimbursements to a doctor or pharmacist once the number of patients they prescribe medications to exceeds the daily maximum, or to apply for reimbursements for drugs that were not prescribed, Kao said.
“The NHIA urges medical institutions and pharmacists to refrain from violating the laws for the sake of a small profit,” Kao said. “We encourage the public to report any suspicious medical facilities to the NHIA.”
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