Community clinics accused of huge healthcare scam

Community clinics accused of huge healthcare scam

A nurse checks a patient's reaction to light. The National Health Security Office has accused 18 community clinics in Bangkok of making thousands of false claims for reimbursement for services under the 30-baht healthcare scheme. (Photo: Jestjaras Na Ranong)
A nurse checks a patient's reaction to light. The National Health Security Office has accused 18 community clinics in Bangkok of making thousands of false claims for reimbursement for services under the 30-baht healthcare scheme. (Photo: Jestjaras Na Ranong)

Thousands of patients will be questioned by police investigating an alleged 72 million baht in fraudulent claims for treatment by community health clinics in Bangkok operating under the government's 30-baht scheme.

Deputy Crime Suppression Division commander Pol Col Somkuan Phuensap said on Friday that as many as 10,000 patients of the rogue clinics may be asked to provide information to investigators. 

The National Health Security Office (NHSO) has registered a complaint against 18 health clinics in Bangkok believed to have swindled 72 million baht from the gold card scheme, also known as the 30-baht universal health plan, in fraudulent claims for treatment of patients.

The clinics join the NHSO by treating patients from their communities under the chum chon ob oon (community warmth) project. People in the communities get free medical checkups, with the cost covered by the NHSO.

The initiative was aimed at reducing the workload on hospitals, using the clinics for frontline treatment.

Clinics in Bangkok and provinces throughout the country have joined the scheme.

The alleged fraud was detected by an NHSO panel sifting through records of budget spending by the clinics from Oct 1, 2018, to Sept 30 last year.

The suspected huge fraud was made public by Pradermchai Boonchuaylue, a Pheu Thai Party MP for Bangkok. He said clinics had listed false names for non-existent patients who supposedly received medical examinations, and used them to claim reimbursements from the NHSO.

However, the complaint lodged by the NHSO says the clinics had changed the health records of their patients, adding false information so they could claim additional reimbursement. 

For example, the health record of a patient with a normal body mass index would be changed to indicate a greater risk to health, so the clinic could get more money from the NHSO, Pol Col Somkuan said.

The NHSO would terminate its contract with the clinics, but this meant more than 200,000 members of the health care scheme would need to find new clinics to attend, he said.

Public Health Minister Anutin Charnvirakul said the clinics face criminal charges and will also be sued to recover the damage caused to the state budget 


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