Nghe An: Head of medical station created fake records, took advantage of insurance fund

Accordingly, at Dien Quang Commune Health Station, the verification team of the provincial Social Insurance inspected, verified and compared the health insurance payment request form from January 1, 2018 to February 28, 2018, selecting 20 forms for verification.

Of the 20 patients on the list of health insurance payments at the Health Station, 12 cases could not be verified because the subjects were absent and could not be contacted; the verification team directly worked with the remaining 8 patients.

Conclusion of Nghe An Provincial Social Insurance on verification of health insurance treatment at Dien Quang Commune Health Station, Dien Chau District. Photo: Phuoc Anh

As a result, in addition to 5 patients who used their health insurance cards to receive health insurance treatment at Dien Quang Commune Health Station in accordance with regulations, there were 3 patients who did not receive medical examination and treatment but still had health insurance treatment records at the station. Of these 3 patients, 1 has passed away, 1 is currently residing in Hanoi and 1 did not receive medical examination and treatment!

In addition, the verification team also worked directly with a local resident, Mr. Le Van T. - residing in Hamlet 3. He affirmed that on February 6, 2018, he did not go to Dien Quang Commune Health Station for health insurance examination and treatment, the signature on the payment form for medical examination and treatment costs and the prescription signed and prepared by the Doctor - Station Chief was not his.

During the working process, the Head of Dien Quang Commune Health Station admitted that from January to February 2018, he had created 5 fake health insurance records to pay health insurance costs without the patient being present. The amount of money requested for payment from the fake records was 432,040 VND.

Thanks to timely detection, the amount of money stolen from the Health Insurance Fund was not large, but the actions of the Head of Dien Quang Commune Health Station violated the regulations on establishing medical records and prescribing drugs without patients as stipulated in Article 66, Decree No. 176/2013/ND-CP dated November 14, 2013 of the Government regulating administrative sanctions for violations in the health sector.

Illustration photo.

Nghe An Provincial Social Insurance does not accept payment of the amount due to the false records of Dien Quang Commune Health Station. At the same time, it is requested that relevant agencies, based on their functions, impose administrative sanctions on the Head of the Commune Health Station; remedy the consequences caused by the administrative violations of the subject; immediately rectify the shortcomings in the work of health insurance examination and treatment, perform examination, make health insurance records, prescribe and dispense medicine to the right patients and strictly check the health insurance examination and treatment procedures for people with health insurance cards when going for medical examination and treatment...

Along with that, an interdisciplinary inspection team was established by the People's Committee of Dien Chau district at Dien Quang Commune Health Station to clarify the creation of fake health insurance records...

Phuoc Anh