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By Lee I-chia / Agents reporter
The National Health Allowance Administration (NHIA) bygone warned the accessible that it would seek to compensate National Health Allowance payments and amercement in cases of accurate allowance fraud, citation as an archetype women who had claimed reimbursements for allegedly defective emergency cesarean sections while traveling in the US.
Since 2016, the NHIA has anchored its analysis on claims for NHI reimbursements of medical costs in added nations, abnormally in cases of caesarean sections in the US, so the approval amount has collapsed from 63 percent in 2016 to 23 percent in 2018, NHIA official Tung Yu-yun (董玉芸) said.
The Bent Analysis Bureau in 2016 opened an analysis into allegations that a postpartum affliction account bureau had organized “medical tour” bales for Taiwanese women who capital to accord bearing in the US, cogent them how to affirmation US citizenship for their accouchement and how to access agreement — with affected analysis certificates — from the NHIA and the allowance companies that provided their biking insurance.
Photo: Lin Hui-chin, Taipei Times
The New Taipei District Prosecutors’ Office on July 26, 2017, accusable bureau buyer Liu Chao-hsun (柳昭薰) and an agent surnamed Lee (李) on accuse of fraud, forgery, annoying others to accomplish a bent breach and accompanying charges, and additionally accusable several women who alternate in the scheme.
A betray was aboriginal doubtable by an allowance aggregation afterwards it noticed the affinity in claims from women who had undergone caesarean sections while in the US and it appear its suspicions to the Institute of Financial Law and Crime Prevention.
Liu launched a Web armpit in 2013, accouterment advice on how abundant women could pretend to become ill while in the US and charge an emergency caesareans for placenta previa, which occurs back the placenta covers allotment or all of a woman’s cervix, Tung said.
A affected analysis affidavit for placenta previa was provided by a California dispensary so that Liu’s audience could affirmation National Health Allowance agreement and book claims on the biking allowance behavior back they alternate to Taiwan, she said.
Clients were answerable about NT$400,000 (US$13,369 at the accepted barter rate) for the service, and they could affirmation NHI agreement for about NT$25,000 from the NHIA and an boilerplate of NT$300,000 from allowance companies, Tung said.
Liu was bedevilled to one year in prison, seven audience were bedevilled to agreement of differing lengths, while 17 others were accepted deferred case afterwards they accepted to accepting alternate in the arrangement and promised to acknowledgment the allowance money and pay a accomplished of NT$100,000.
Thirty-four of Liu’s audience acquired a absolute of about NT$7 million, including about NT$650,000 in NHI reimbursements, Tung said, abacus that the NHIA would seek NT$25,000 in agreement as able-bodied as a NT$50,000 accomplished from anniversary of the clients.
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