Ma Guang Employees Admit to Fraudulent Health Insurance Claims
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2014/11/08 00:08
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CNA November 7, 2014 Reporter Guo Zhi-Xuan, Pingtung County
The Ma Guang Traditional Chinese Medicine clinic chain is suspected of fraudulently claiming National Health Insurance (NHI) reimbursements. The Pingtung District Prosecutors Office recently summoned 38 employees of Ma Guang, who admitted to using their own or their relatives' NHI cards for fake medical visits to fraudulently claim NHI reimbursements.
In mid-July this year, the Pingtung and Kaohsiung District Prosecutors Offices conducted raids and summoned 13 doctors, including director Huang Fu-Xiang, and one administrative staff member. After questioning, they were released on bail ranging from NT$20,000 to NT$500,000. In August, Huang Fu-Xiang, who denied involvement, was detained.
The prosecutors and police mobilized again, summoning 38 employees from three clinics in Pingtung in batches on the 5th and 6th for questioning.
The prosecutors stated that the involved employees admitted to providing NHI cards for swiping without actual acupuncture treatments. Doctors who were aware of the scheme cooperated in creating fake medical records. Additionally, during relocation openings, anniversary celebrations, and other events held by Ma Guang clinics in 2012 and 2013, employees collected NHI cards from relatives and friends to boost clinic performance metrics without actual consultations, thereby fraudulently claiming NHI reimbursements.
All 38 employees were released after questioning. The Pingtung prosecutors noted that the total number of implicated medical staff is still under investigation.
Preliminary investigations indicate that the exact amount of NHI funds fraudulently claimed by Ma Guang over three years is still being calculated, with each fake consultation costing around NT$400 to NT$500.
The Pingtung prosecutors urged former employees and their relatives who have not yet come forward to voluntarily confess and assist in clarifying the criminal facts.
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