Taipei prosecutors on Thursday indicted 109 suspects in a case of medical insurance fraud that allegedly involved the Dianthus Medical Group, some of its patients, and several insurance sales agents.
The suspects charged with fraud and document forgery included Dianthus Medical Group CEO Lin Tzu-hung (???), four doctors and other medical personnel employed with the company, and 19 insurance agents, the Taipei District Prosecutors Office said.
In addition, 80 mothers who had been patients at Dianthus were among the 109 people indicted in the medical insurance fraud case, prosecutors said.
According to the Dianthus website, the group currently operates 12 clinics in Taiwan — 10 in Taipei and two in Taoyuan — that specialize in maternal-fetal medicine (MFM), gynecology, obstetrics, pediatrics, dentistry and ophthalmology.
Prosecutors said they launched an investigation into the operations of the medical company after Hontai Life Insurance reported earlier this year that it had found discrepancies in many of the claims filed by Dianthus patients.
The claims, which were specific to five Dianthus clinics, were based on false medical information, with the aim of obtaining private insurance reimbursements, prosecutors said.
For instance, they said, women were allegedly submitting insurance claims for unavoidable cesarean (C-section) deliveries, when in fact they had opted to give birth by that means, prosecutors said.
The insurance claims falsely cited childbirth complications such as “malpresentation of the fetus” that required C-section surgery, prosecutors said.
The 19 insurance sales agents charged on Thursday had allegedly colluded with Dianthus in such cases, in a bid to gain customers, according to prosecutors.
The case involved 10 insurance companies, and the gains from the alleged fraud and forgery amounted to some NT$67 million (US$2.23 million, prosecutors said.
On Thursday, the Taipei District Prosecutors office said it will be seeking harsh penalties for Lin and the other four doctors in the case, as they had tarnished the reputation of physicians and the medical insurance system nationwide.
Source: Focus Taiwan News Channel