How is health insurance fraud handled?

Health insurance fraud is the act of fraudulently creating medical records, prescribing false drugs, or prescribing increased quantities, or adding drugs, medical supplies, technical services, hospital bed costs and other costs that the patient does not actually use; Forging records, health insurance cards or using fake health insurance cards, revoked cards, altered cards, or health insurance cards of others in medical examination and treatment to enjoy health insurance benefits in violation of regulations to appropriate health insurance money.

Article 215 of the 2015 Penal Code stipulates the crime of health insurance fraud as follows:

1. Anyone who commits one of the following acts, appropriating health insurance money from VND 10,000,000 to under VND 100,000,000 or causing damage from VND 20,000,000 to under VND 200,000,000, not falling under the cases specified in one of Articles 174, 353 and 355 of this Code, shall be subject to a fine from VND 20,000,000 to VND 100,000,000, non-custodial reform for up to 02 years or imprisonment from 03 months to 02 years:

a) Creating medical records, prescribing false drugs or prescribing increased quantities or additional types of drugs, medical supplies, technical services, hospital bed costs and other costs that the patient does not actually use;

b) Forging documents, health insurance cards or using falsely issued health insurance cards, fake health insurance cards, revoked cards, modified cards, or other people's health insurance cards for medical examination and treatment to enjoy health insurance benefits in violation of regulations.

2. Committing a crime in one of the following cases shall be subject to a fine of from VND 100,000,000 to VND 200,000,000 or imprisonment from 01 year to 05 years:

a) Organized;

b) Professional in nature;

c) Appropriating health insurance money from VND 100,000,000 to under VND 500,000,000;

d) Causing damage from VND 200,000,000 to under VND 500,000,000;

d) Using sophisticated and cunning tricks;

e) Dangerous recidivism.

3. Committing a crime in one of the following cases shall be punishable by imprisonment from 05 years to 10 years:

a) Appropriating health insurance money of VND 500,000,000 or more;

b) Causing damage of VND 500,000,000 or more.

4. The offender may also be fined from VND 10,000,000 to VND 100,000,000, banned from holding positions, practicing a profession or doing certain jobs from 01 year to 05 years.