Gyeonggi-do Cracks Down on 11 Cases of Fraudulent Medical Benefit Claims by Basic Livelihood Recipients

[Asia Economy (Suwon) = Reporter Lee Young-gyu] Gyeonggi Province has imposed fines totaling 1.7 billion KRW on 11 medical institutions that violated the Medical Care Assistance Act by fraudulently claiming drug costs or excessively charging co-payments for basic livelihood security recipients.

This fine imposition is a follow-up measure based on the "Investigation of Suspected Fraudulent Medical Care Assistance Claims" conducted nationwide by the Ministry of Health and Welfare during the first half of the year.

Typically, detected institutions receive suspension of business operations, but if special circumstances such as inconvenience to users are recognized, fines may be imposed and collected instead.

The 11 detected institutions were found to have illegally claimed medical care assistance fees by providing medical services to basic livelihood security recipients while engaging in ▲false claims of visit days ▲fraudulent drug cost claims ▲excessive co-payment collection ▲violations of the differentiated calculation standards for nursing hospital admission fees.

The current "Medical Care Assistance Act" stipulates that if a medical care institution causes recipients, supporters, or mayors and county heads to bear benefit costs through deception or other unfair methods, or if they claim co-payments in advance or other costs such as hospitalization deposits, the institution may be ordered to suspend operations for up to one year. Additionally, the Minister of Health and Welfare may delegate the authority to collect imposed fines to the city or provincial governors.

The province plans to take follow-up actions such as suspending operations against institutions that fail to pay fines by the deadline.

Kim Tae-hoon, Director of the Welfare Project Division of the province, emphasized, "We will thoroughly manage the proper use of welfare budgets by cooperating with the Ministry of Health and Welfare and city and county governments to prevent additional violations such as non-payment by medical institutions notified of fine imposition."