Medical Insurance Scam - Anhui Province

Dozens of health care facilities in the eastern Anhui province were found to have misappropriated nearly 58 million yuan ($9 million) from the public health insurance fund. Provincial authorities have revoked four hospitals’ medical licenses, as well as the professional credentials of 14 employees at Taihe County’s health security administration following an investigation on malpractice. A total of 19 officials in the county — as well as in Fuyang, the city that administers Taihe — have been held accountable for the scam, though it’s unclear if they have received any punishments.

Authorities combed through hundreds of thousands of patients’ medical records from the county’s 50 health care facilities after media reports exposed that the health security administration — entrusted with operating the medical insurance fund — was misappropriating funds from public coffers. All investigated health facilities were found to have been engaged in varying degrees of fraud.

Following the investigation, nine of the county’s private hospitals have voluntarily applied to suspend or stop their public health insurance services. Of the 1.38 million residents in Taihe County, nearly 18% are aged 60 and above, with many requiring frequent medical assistance. 

Despite strict government supervision, scams involving the public insurance fund have time and again made headlines in China. In 2017, two private hospitals in the northeastern city of Shenyang were exposed for hiring “patients” through a third party, while falsifying their medical records and prescribing medicines that mainly benefitted the hospital.