Clipping Board » Medical Affairs and Administration ─ Medical system, pharmaceuticals, and medical community-related reports
March 28, 2012 [Liberty Times reporter Chen Wenchan/Kaohsiung report]
The Kaohsiung City Criminal Investigation Bureau cracked down on a fraud ring led by an 80-year-old Yuan surnamed doctor, who was suspected of falsifying medical records to fraudulently claim National Health Insurance (NHI) reimbursements. Patients who presented two or more different NHI cards for medical visits were exempted from registration fees and could even exchange them for whitening injections or health supplements. Over four years, the group fraudulently claimed more than NT$10 million. Police arrested four suspects yesterday, with the doctor’s wife even defiantly telling officers they were "doing charity work." After questioning, the suspects were charged according to the law.
### 80-Year-Old Doctor Leads Scheme, Swindling Over NT$10 Million in 4 Years
#### Falsified Medical Records to Defraud NHI, Claimed They Were "Doing Charity Work"
Police investigations revealed that the main suspect, Dr. Yuan (82), was originally a military doctor who came to Taiwan with the Nationalist government. In June 2007, he opened a clinic in Renwu District, collaborating with his wife (70), a Li surnamed pharmacist (64, with prior convictions under the Pharmaceutical Affairs Act), and a Huang surnamed nurse (42) to falsify medical records and systematically claim fraudulent NHI reimbursements from the Bureau of National Health Insurance.
### Presenting 2 or More NHI Cards Could Exchange for Health Supplements
The investigation showed that the group exploited people’s tendency to seek small advantages, encouraging patients to present two or more different NHI cards for medical visits. This allowed them to waive registration fees and even exchange for whitening injections, liver medications, vitamins, and other health supplements, further enticing patients to bring friends and family for check-ups.
Police noted that the group even marked the medical records of cooperating patients. One child’s NHI card was used over ten times by their parents, while a 54-year-old Xie surnamed man once presented six cards in a single visit to obtain multiple health supplements.
### Over 20 Patients Testified, 4 Suspects Charged
Officers from the Eighth Brigade of the Kaohsiung City Criminal Investigation Bureau received a tip last year. After analyzing the clinic’s medical records and cross-checking card-swiping data, they discovered anomalies in over 40 records and summoned more than 20 patients, who provided detailed testimonies.
Police arrested the four suspects yesterday. Yuan’s wife defiantly told officers, "We didn’t charge for medical visits; we were doing charity work." Authorities seized falsified medical records and computer equipment, uncovering over NT$10 million in fraudulent claims over four years.
Yuan and two others denied wrongdoing, claiming complete ignorance and shifting all blame onto the nurse. The nurse, however, stated that the doctor and his wife instructed patients to present different NHI cards, after which Dr. Yuan falsified the treatment records. After questioning, all four were charged with fraud and forgery.Source: http:/ / tw. news. yahoo. com/ 8% E……6% 84% E4% BA% 8B- 204325894. html;_ylt=AqqSCzerf7nKoM7ED7maTlqVBdF_;_ylu=X3oDMTQ3N3VmN2luBG1pdANTZWN0aW9uTGlzdCBGUCBTb2NpZXR5BHBrZwM4NzJlODk2Mi01ZDliLTM4NDUtYmQ0Zi05YTBhZTY5ZmQ4YjcEcG9zAzMEc2VjA01lZGlhU2VjdGlvbkxpc3QEdmVyA2ZkOGY2ODQ5LTc4YTAtMTFlMS1iZmY2LTU2ODc1MzUzMmJkMw--;_ylg=X3oDMTF0aGg1ZmNzBGludGwDdHcEbGFuZwN6aC1oYW50LXR3BHBzdGFpZAMEcHN0Y2F0A2hvbWUEcHQDc2VjdGlvbnMEdGVzdAM-;_ylv=3
80-Year-Old Doctor Leads $1M+ Medicare Fraud over 4 Years / Faked Records, Claimed "Charity" to Police
The Kaohsiung City Criminal Investigation Bureau cracked down on a fraud ring led by an 80-year-old Yuan surnamed doctor, who was suspected of falsifying medical records to fraudulently claim National Health Insurance (NHI) reimbursements. Patients who presented two or more different NHI cards for medical visits were exempted from registration fees and could even exchange them for whitening injections or health supplements. Over four years, the group fraudulently claimed more than NT$10 million. Police arrested four suspects yesterday, with the doctor’s wife even defiantly telling officers they were "doing charity work." After questioning, the suspects were charged according to the law.
### 80-Year-Old Doctor Leads Scheme, Swindling Over NT$10 Million in 4 Years
#### Falsified Medical Records to Defraud NHI, Claimed They Were "Doing Charity Work"
Police investigations revealed that the main suspect, Dr. Yuan (82), was originally a military doctor who came to Taiwan with the Nationalist government. In June 2007, he opened a clinic in Renwu District, collaborating with his wife (70), a Li surnamed pharmacist (64, with prior convictions under the Pharmaceutical Affairs Act), and a Huang surnamed nurse (42) to falsify medical records and systematically claim fraudulent NHI reimbursements from the Bureau of National Health Insurance.
### Presenting 2 or More NHI Cards Could Exchange for Health Supplements
The investigation showed that the group exploited people’s tendency to seek small advantages, encouraging patients to present two or more different NHI cards for medical visits. This allowed them to waive registration fees and even exchange for whitening injections, liver medications, vitamins, and other health supplements, further enticing patients to bring friends and family for check-ups.
Police noted that the group even marked the medical records of cooperating patients. One child’s NHI card was used over ten times by their parents, while a 54-year-old Xie surnamed man once presented six cards in a single visit to obtain multiple health supplements.
### Over 20 Patients Testified, 4 Suspects Charged
Officers from the Eighth Brigade of the Kaohsiung City Criminal Investigation Bureau received a tip last year. After analyzing the clinic’s medical records and cross-checking card-swiping data, they discovered anomalies in over 40 records and summoned more than 20 patients, who provided detailed testimonies.
Police arrested the four suspects yesterday. Yuan’s wife defiantly told officers, "We didn’t charge for medical visits; we were doing charity work." Authorities seized falsified medical records and computer equipment, uncovering over NT$10 million in fraudulent claims over four years.
Yuan and two others denied wrongdoing, claiming complete ignorance and shifting all blame onto the nurse. The nurse, however, stated that the doctor and his wife instructed patients to present different NHI cards, after which Dr. Yuan falsified the treatment records. After questioning, all four were charged with fraud and forgery.Source: http:/ / tw. news. yahoo. com/ 8% E……6% 84% E4% BA% 8B- 204325894. html;_ylt=AqqSCzerf7nKoM7ED7maTlqVBdF_;_ylu=X3oDMTQ3N3VmN2luBG1pdANTZWN0aW9uTGlzdCBGUCBTb2NpZXR5BHBrZwM4NzJlODk2Mi01ZDliLTM4NDUtYmQ0Zi05YTBhZTY5ZmQ4YjcEcG9zAzMEc2VjA01lZGlhU2VjdGlvbkxpc3QEdmVyA2ZkOGY2ODQ5LTc4YTAtMTFlMS1iZmY2LTU2ODc1MzUzMmJkMw--;_ylg=X3oDMTF0aGg1ZmNzBGludGwDdHcEbGFuZwN6aC1oYW50LXR3BHBzdGFpZAMEcHN0Y2F0A2hvbWUEcHQDc2VjdGlvbnMEdGVzdAM-;_ylv=3