Health ministry names 58 clinics, pharmacies for false insurance claims

South Korea's health ministry said Thursday it will publish for six months the names of 58 medical institutions and pharmacies that falsely claimed national health insurance benefits.

The 58 institutions — two hospitals, 36 clinics, 10 dental clinics, eight oriental medicine clinics and two pharmacies — together filed 4.67 billion won ($3.43 million) in false claims, the Ministry of Health and Welfare said. The largest single false claim totalled 927 million won, and the average was 80.5 million won per institution. The claims were filed over an average of 31 months, and one institution's false billings equalled 55.34 percent of its total benefits.

The ministry cited two cases to illustrate the patterns: one clinic billed for more radiology scans than it actually performed, claiming 45.4 million won over 36 months, and another fabricated visits to bill for consultations and oriental medicine procedures, claiming 927 million won over 17 months. Both had their gains recovered, were fined, named and reported to prosecutors on fraud charges.

The list will be posted from Oct. 1 through March 31 on the websites of the ministry, the Health Insurance Review and Assessment Service, the National Health Insurance Service, and local governments and public health centers. Published details include each institution's name, address and type, its representative's name and license number, the violation and the administrative penalty imposed.

We will continue to carry out on-site inspections of institutions suspected of false claims and strictly enforce the publication of names, separately from administrative penalties, to raise awareness of false billing and prevent waste of health insurance finances, said Yoo Joo-heon, head of the ministry's health insurance policy bureau.