Chinese spouse involved in NHI card fraud costs nation NT$900,000

Taipei, In a recent case involving medical identity theft, the Chinese spouse of a Taiwanese citizen was found to have lent her National Health Insurance (NHI) card to her cousin, who was suffering from gastric cancer.

The cousin's doctor visits last year led to nearly NT$900,000 (US$29,430) in medical expenses covered by the NHI system up until her death.

From 2014 till now, 35 cases of fraudulent use of NHI cards have been reported, involving illegal spending of NT$1.75 million in medical expenditures, National Health Insurance Administration DirectorGeneral Lee Pochang ) said Monday, citing official statistics.

Of the 35 fraudulent users of NHI cards, 19 were foreign nationals, most of whom were unaccounted for migrant workers, while 16 were Taiwanese nationals, most of whom were fugitives who did not want to expose their identities, according to Lee.

The Chinese spouse's cousin, who was not covered by the system, used her NHI card for medical and surgical treatment, incurring NT$900,000 in medical expenditures covered by the system, the biggest single amount in any NHI card fraud case.

It was not uncovered until the cardholder confessed that she lent her NHI card to her cousin when the doctor was about to issue a death certificate to the cardholder, Lee said.

After an investigation, the cardholder was sentenced to four months in prison, suspended for two years, and was told to repay the relevant medical bills, he added.

Most of the other fraud cases involved sums ranging from several hundred Taiwan dollars to up to NT$10,000 and were granted a non prosecution or a deferred prosecution, Lee said.

However, these cases were just the tip of the iceberg and there are likely to be many more, Lee added.

Most of the misused NHI cards do not bear a photograph of the holder, Underwriting Division official Wu Hsin said, adding that to prevent similar cases, the administration launched a new regulation in January 2018 requiring those applying for or renewing NHI cards to provide a photo. About 20 percent of NHI cards do not have a photo.

The administration has sent notification requiring hospitals and medical institutions to strictly implement the verification of ID cards and NHI cards before offering medical treatment to patients, according to Wu.

Source: Focus Taiwan News Channel