FAKE CLAIMS: The agency cited its efforts to recover money paid to cover supposed emergency caesareans in the US as well as damages from the women involved

Taipei Times
Date: May 13, 2020
By: Lee I-chia / Staff reporter

The National Health Insurance Administration (NHIA) yesterday warned the public that it would seek to recoup National Health Insurance payments and damages in cases of proven insurance fraud, citing as an example women who had claimed reimbursements for supposedly needing emergency cesarean sections while traveling in the US.

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.

The Criminal Investigation Bureau in 2016 opened an investigation into allegations that a postpartum care service agency had organized “medical tour” packages for Taiwanese women who wanted to give birth in the US, telling them how to claim US citizenship for their children and how to obtain reimbursement — with fake diagnosis certificates — from the NHIA and the insurance companies that provided their travel insurance.

The New Taipei District Prosecutors’ Office on July 26, 2017, indicted agency owner Liu Chao-hsun (柳昭薰) and an employee surnamed Lee (李) on charges of fraud, forgery, inciting others to commit a criminal offense and related charges, and also indicted several women who participated in the scheme.    [FULL  STORY]