Wednesday, September 20, 2017

Cost of fraudulent NHI claims hits new record in Taiwan

Fraudulent transactions involving National Health Insurance (NHI) payments hit a record NT$221.19 million (US$6.92 million) in Taiwan last year, the National Health Insurance Administration (NHIA) announced.

The agency reinforced its investigation efforts last year in response to the increased collusion between healthcare practitioners and the public in using false medical certificates or medical records to declare payments or make insurance claims.

According to NHIA senior official Kao Shih-hao, the false claims for NHI payments from medical facilities increased from NT$68.22 million in 2013 to NT$83.16 million in 2014 and nearly tripled last year.

Among the 2,285 medical facilities it investigated in the past three years, 1,108 were found to have breached the regulations, Kao said.

The agency said that an otolaryngology clinic in China’s Guangdong province operated by Taiwanese has a medical licence in China, but not in Taiwan.

The clinic provided more than 9,000 medical certificates to more than 2,400 Taiwanese, which were used to claim reimbursements for overseas medical expenses in the past two years, according to the agency.

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