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official response to "wuxi hongqiao hospital suspected of insurance fraud": administrative case has been filed and is being thoroughly investigated

2024-09-22

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according to cctv news, on september 21, the central radio and television station reported that wuxi hongqiao hospital, a private medical institution in wuxi, was suspected of insurance fraud. the wuxi municipal medical insurance bureau issued a notice in the early morning of september 22 to respond that it had accepted the investigation and preliminary verification based on the reported clues, and filed an administrative case on august 30; it is currently conducting a comprehensive and thorough investigation in conjunction with the public security, health and other departments, and will severely investigate and deal with it in accordance with the law.

previous reports

recently, dr. zhu from the radiology department of wuxi hongqiao hospital in jiangsu province reported to the china voice news hotline 400-800-0088 under his real name that since last year, some medical records of patients who had never undergone imaging examinations in their department have appeared in the hospital system, but the medical records have "diagnoses based on imaging." all these medical records were completed by dr. chen from the hospital's physical examination center, and this doctor did not have the authority to operate the ct and mri machines in the radiology department.

the problematic medical record taken by dr. zhu in march 2024 contains relevant content based on imaging diagnosis, but does not contain images or imaging numbers.

dr. zhu suspected that the hospital was involved in falsifying medical records and defrauding medical insurance. in march this year, he took photos of the medical records without imaging numbers as evidence and reported them to the hospital's higher management department under his real name. while waiting for the results of the investigation, the medical records he reported had imaging numbers and films. subsequently, he discovered more problems, including: