Dozens arrested in China over public medical insurance scam

Alice Yan, South China Morning Post

Posted at Oct 10 2021 07:32 AM

Dozens of employees of a private hospital in southwestern China have been arrested, accused of defrauding a public medical insurance scheme of more than 10 million yuan (US$1.55 million), according to Chinese media.

In all, 47 employees, including the director of Mintai Hospital in Xuanhan county, Sichuan province, were detained, suspected of falsifying medical records and accounts to cover operating costs, shareholder dividends and marketing expenses, China Business News reported.

Li Yinan, from Sichuan's Department of Public Security, was quoted as saying that the alleged fraud was shocking.

"It seriously infringed patients' rights, threatened the safety of our country's medical insurance fund scheme and damaged social order," he was quoted as saying.

The arrests come as the Ministry of Public Security, the National Health Commission and the National Healthcare Security Administration try to crack down on fraud in the medical insurance system, which covers more than 95 per cent of the country's population and is under strain as society ages.

According to the report, the hospital staff allegedly fabricated 228 hospitalisations involving 165 people.

Employees were also offered a 300 yuan incentive for every patient they introduced to the medical facility, the report said.

Doctors allegedly prescribed unnecessary drugs, ordered unnecessary checks, and falsified records to suggest patients stayed longer than they had, according to Li.

The hospital's clinical laboratory is also accused of modifying patients' results to convince them to be hospitalised.

In addition, the nursing department allegedly falsified nursing records, falsely executed doctors' advice and in some cases, destroyed drugs that have been overprescribed.

Separately, police in Shanghai said they had arrested 150 people allegedly involved in scams to sell drugs bought through the medical insurance fund.

According to China Business News, the suspects are accused of approaching patients outside hospitals and offering to buy their medication at up to half of the drugs' price.

The suspects then allegedly sold the drugs on social media platforms without a pharmaceutical licence at about 60 per cent of the retail price.

The police were quoted as saying that most of the drugs involved were for chronic diseases and traditional Chinese medicines.

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