Health ministry receives 102 reports of suspected fake medical treatment

The health ministry said Tuesday its center for reporting abnormal and fake medical treatment had received 102 reports of suspected illegal or improper practices.

The reports were filed as of Aug. 7, about 50 days after the center opened alongside the ministry's administrative investigation team on June 15.

Reports included suspected false or improper billing, illegal treatment-fee rebates or paybacks, and patient solicitation. False or improper billing accounted for 27 cases, while paybacks and patient solicitation each accounted for 26. Nine reports concerned non-covered treatment packages, and three involved suspected hospitals operated by non-medical personnel. Clinics accounted for 26 reports, followed by Korean medicine hospitals with 23 and nursing hospitals with 21.

One tip alleged that a hospital fabricated inpatient records for people who had not been admitted, helped them claim insurance payments and returned part of their legally required co-payments. Other reports described alleged online referral arrangements through internet forums and social media, under which existing patients received points redeemable for hospital-provided special meals, spa services or transport after bringing in other patients.

The team has referred 18 medical institutions for investigation and is weighing further referrals, including involving facilities inspected in July. The ministry said reports will undergo big-data analysis by the National Health Insurance Service and the Health Insurance Review and Assessment Service before on-site administrative inspections.

"Abnormal and fake medical treatment is a serious illegal act that disrupts the medical order and harms people's lives and health, as well as eroding trust in national health insurance and private insurance systems," Kwak Soon-heon, head of the administrative investigation team, said.

"We will actively consider deploying additional administrative resources to eradicate illegal and improper practices as the number of reports, the types of abnormal and fake treatment and suspected institutions increase," Kwak said.

Health-care workers, patients and family members can report suspected practices to the center by telephone or email.