news

한어Русский языкEnglishFrançaisIndonesianSanskrit日本語DeutschPortuguêsΕλληνικάespañolItalianoSuomalainenLatina

recently, wuxi hongqiao hospital has attracted widespread public attention for allegedly falsifying medical records and defrauding medical insurance funds.

on september 24, the wuxi municipal medical insurance bureau issued a report on the situation. it continued to conduct a comprehensive investigation into the suspected medical insurance fraud of wuxi hongqiao hospital together with the public security, health and other departments. at present, the hospital's insurance fraud has been basically verified. on september 22, the wuxi municipal medical insurance bureau cancelled the hospital's medical insurance designated qualification, and the public security organs filed a criminal case. on september 23, the legal representative, the president and 15 other persons involved in the case of wuxi hongqiao hospital have been taken criminal compulsory measures by the public security organs in accordance with the law. the private hospital has now closed down.

previous reports

dr. zhu chenggang from the radiology department of wuxi hongqiao hospital reported that since july 2023, when he reviewed past medical records, he found that some patients' medical records did not have "image numbers" or computed tomography (ct) or mri images, but the medical records contained "diagnosis based on imaging". these medical records were written by dr. chen from the hospital's physical examination center, and this doctor did not have the authority to operate the ct or mri machines in the radiology department.

in addition, in march this year, dr. zhu reported the case to the hospital's superior management department under his real name, but before the investigation results were released, he discovered that the medical records he reported had new imaging numbers and films. however, the films that were temporarily added were full of loopholes. the images of many patients were highly similar to those of others, two mri examinations were performed within one minute, and the left-right correspondence between the images and the diagnosis was incorrect.

dr. zhu chenggang said that he had reported the hospital's insurance fraud to the wuxi medical insurance bureau, but the department disagreed, saying that it took too long, too much reporting material, and too many people involved, making it impossible to determine.

zhu chenggang told reporters that after he reported the incident, the doctors in the radiology department lost access to their work computers and work accounts to open patient examination records.

manual registration books for imaging examinations have disappeared

on september 23, the national healthcare security administration dispatched a flying inspection team to wuxi hongqiao hospital to carry out special flying inspections.

the staff of the national medical insurance administration's flight inspection team used the method mentioned by dr. zhu to retrieve some imaging examination records from 2023 in the existing system and found that the examination time and the serial number automatically generated by the imaging examination equipment did not match. in addition, when the inspection team asked the hospital to issue a manual registration record book for imaging examinations, the manual registration record book that could prove whether the patient had actually undergone an imaging examination disappeared.

the investigation found that many of the imaging records and medical records of wuxi hongqiao hospital, which should have been registered in the radiology department, were registered in the name of the physical examination center due to deletion, permission blocking, and complex division of departments, which hindered the inspection team from further inspection. the national medical insurance administration's unannounced inspection team asked the local medical insurance department and hospital to take various measures to restore the accessibility and verification of imaging records as soon as possible.

yuan hui, director of the supervision division of the fund supervision department of the national healthcare security administration, said that because he had reported it before but it is gone now, the data must have been destroyed. according to article 40, paragraph 2 of the regulations on financial supervision of medical insurance funds, it is considered as destruction of medical insurance electronic information.

wuxi hongqiao hospital's destruction of fraudulent insurance data to resist investigation has undoubtedly aggravated the severity of its illegal behavior. this behavior is not only a challenge to the majesty of the law, but also a betrayal of public trust. in contrast, the severity of the corresponding accountability cannot be ignored. at present, the wuxi municipal medical insurance bureau has revoked its medical insurance designated qualification, the public security organs have filed a case for investigation, and have taken criminal compulsory measures against 15 people involved in the case, including the legal representative and dean of the hospital.

another hospital under the same group was investigated last month.

public information shows that wuxi hongqiao hospital is a private class ii hospital established in 2005 and is a designated medical insurance unit in wuxi. the major shareholder of wuxi hongqiao hospital is shanghai media hospital investment group co., ltd., which holds 40% of the shares. media hospital investment group is held by wang weimin and hu yuzhi, with a shareholding ratio of 80% and 20% respectively. among them, wang weimin serves as the chairman and president of the group, the executive director and manager of kunshan hongqiao hospital, and hu yuzhi is the dean of wuxi hongqiao hospital.

in august this year, it was revealed that "doctors had to make patients spend 7,000 yuan" at kunshan hongqiao hospital, a subsidiary of media hospital investment group. on august 28, the kunshan municipal health commission issued a report on the situation, announcing that it had officially filed a case against kunshan hongqiao hospital and launched an investigation in accordance with the law.

in addition, many hospitals under media have been punished for suspected irregular use of medical insurance funds. for example, in january 2024, shenzhen honglong hospital was fined because obstetric nurses failed to implement the checking system, which resulted in pregnant women falsely obtaining birth certificates for their babies. from 2022 to 2023, shanghai jianqiao hospital and wenzhou jianguo hospital were fined several times for excessive examinations, repeated charges, and excessive charges and other irregular use of medical insurance funds.

written by anna.an

editor | swagpp