The deputy director of Thai An Hospital and six nurses have been indicted for falsifying medical records and defrauding insurance companies.
(Baonghean.vn) - On July 31, the Investigation Police Agency of Vinh City Police issued a decision to initiate a criminal case and prosecute the defendants for the crime of "Health insurance fraud" as stipulated in Article 215 of the Penal Code.
Previously, through intelligence gathering, the Vinh City Police discovered a group of individuals regularly colluding with medical staff at hospitals in the province to create fraudulent medical records for the purpose of profiting from commercial and health insurance. Under the direction of the Provincial Police Director, the Vinh City Police established a special task force to combat and dismantle this group.
After a period of focused investigation, the police identified several individuals in Vinh City and surrounding areas who intended to fraudulently obtain health insurance and commercial insurance benefits. They colluded with nurses Nguyen Thi Hang (born 1991), Dang Thi Anh Tu (born 1984), Le Thi Thanh Tam (born 1986), Luong Thi Be (born 1982), Tran Thi Hue (born 1988) and doctors Hoang Dang Thanh (born 1986) and Dinh Thi My Dung (born 1959) of Thai An General Hospital to create fraudulent records.
Individuals covered by health insurance or commercial insurance who are not ill and do not need medical examination or treatment are lured by "brokers" to Thai An General Hospital for the purpose of fraudulently claiming health insurance benefits. There, the individuals provide their citizen identification cards and health insurance cards to nurses Nguyen Thi Hang or Dang Thi Anh Tu to complete the admission procedures and are directed to the interdisciplinary department to meet with doctors Hoang Dang Thanh or Dinh Thi My Dung to formalize the examination and treatment procedures.
Every day, even though the patients were not receiving treatment at the hospital, doctors Hoang Dang Thanh or Dinh Thi My Dung and nurses Nguyen Thi Hang, Dang Thi Anh Tu, Le Thi Thanh Tam, Luong Thi Be, and Tran Thi Hue all participated in signing blank medical records. Once the required number of days for the medical record had been completed, the administrative nurse would notify the person named in the record to come and sign the necessary paperwork and pay the hospital fees according to the completed record. Some individuals who did not come to the hospital in person to sign the admission and discharge procedures would take photos of their citizen identification cards and health insurance cards and send them via phone to the nurses and doctors to create the records, which were then signed by someone else.
Initially, the Vinh City Police Investigation Agency clarified that from 2021 to early 2023, Thai An General Hospital fabricated 153 medical records. Of these, 59 records were created using health insurance cards, resulting in Thai An General Hospital receiving over 100 million VND in reimbursement for medical expenses from the Nghe An Provincial Social Insurance. The individuals named in these records paid over 200 million VND in hospital fees to Thai An General Hospital. After receiving the falsified medical records from Thai An General Hospital, these individuals fraudulently claimed benefits (hospitalization support) from commercial insurance companies totaling over 2 billion VND.
At the investigative agency, doctors, nurses, related individuals, and those whose records were included in the medical files all confessed to participating in the falsification of medical records. The actions of these individuals caused losses to the health insurance fund and damaged the reputation of hospitals and medical facilities.
Currently, the Investigation Police Department of Vinh City Police has issued a decision to initiate criminal proceedings against 7 defendants, all nurses and doctors of Thai An General Hospital, for the crime of "Medical Insurance Fraud" as stipulated in Article 215 of the Penal Code. These defendants include: Dinh Thi My Dung (born 1959) - Deputy Director and Head of the Interdisciplinary Department; Tran Thi Hue (born 1988) - Head of the Nursing Department; Hoang Dang Thanh (born 1986), Nguyen Thi Hang (born 1991), Dang Thi Anh Tu (born 1984), Le Thi Thanh Tam (born 1986), and Luong Thi Be (born 1982).
The police are continuing to investigate the actions of other individuals involved.
