Borrowing health insurance card to go to the doctor can result in imprisonment

Illustration photo.

According to social insurance experts, based on the provisions of Clause 2, Article 37 of the Law on Health Insurance amended and supplemented in 2014, health insurance participants have the obligation to: "Use the health insurance card for the right purpose, do not lend the health insurance card to others".

Along with that, Article 65 of Decree 76/2013/ND-CP stipulates:“2. Fines for lending health insurance cards to others or using other people's health insurance cards for medical examination and treatment at one of the following levels:

a) From VND 500,000 to VND 1,000,000 for violations that have not caused damage to the health insurance fund;

b) From VND 1,000,000 to VND 2,000,000 for violations causing damage to the health insurance fund.

3. Remedial measures:

a) Force the refund of the amount paid by the health insurance fund to the health insurance fund's collection account for the acts specified in Point b Clause 1 and Point b Clause 2 of this Article;

b) Forcing health insurance card users to refund all medical examination and treatment costs paid by the health insurance fund to the health insurance fund's collection account for the acts specified in Point b Clause 1 and Point b Clause 2 of this Article;

c) Recommend competent state agencies to revoke health insurance cards for acts specified in Clause 1 of this Article.”

In particular, from January 1, 2018, the revised Penal Code officially took effect, which clearly stipulates that the crime of Health Insurance fraud can be punished with imprisonment. Specifically:

Article 215. Crime of health insurance fraud

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.

"Thus, the act of lending or borrowing someone else's health insurance card for medical examination and treatment is against the law" - said an expert in the field of social insurance./.