Since 2016, the NHIA has tightened its review on claims for NHI reimbursements of medical expenses in other nations, especially in cases of caesarean sections in the US, so the approval rate has fallen from 63 percent in 2016 to 23 percent in 2018, NHIA official Tung Yu-yun (董玉芸) said. National Health Insurance Administration Director-General Lee Po-chang holds a placard giving details of an insurance fraud at a news conference in Taipei yesterday. A fake diagnosis certificate for placenta previa was provided by a California clinic so that Liu’s clients could claim National Health Insurance reimbursement and file claims on the travel insurance policies when they returned to Taiwan, she said. Clients were charged about NT$400,000 (US$13,369 at the current exchange rate) for the service, and they could claim NHI reimbursement for about NT$25,000 from the NHIA and an average of NT$300,000 from insurance companies, Tung said. Thirty-four of Liu’s clients obtained a total of about NT$7 million, including about NT$650,000 in NHI reimbursements, Tung said, adding that the NHIA would seek NT$25,000 in reimbursement as well as a NT$50,000 fine from each of the clients.

Source: Taipei Times May 12, 2020 15:56 UTC