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Shenzhen Targets Insurance Fraud

Shenzhen's labor and social security bureau announced Tuesday that more than 20 local hospitals and drugstores were punished for breaking medical insurance fund regulations.

Most violators provided services to those who used prescriptions to obtain non-medicine goods, received medical service on someone else's insurance card or obtained card-financed medicine for relatives and friends.

Yuanling Hospital, accused of carrying out most violations, was eliminated from the designated medical insurance provider list and fined 20,000 yuan (US$2,400). The hospital was also forced to return 168,000 yuan (US$20,298) in misused funds.

Shenzhen Nepstar Drugstore (Guiyuan branch) was also struck off the list after it exchanged hospital prescriptions for milk, mineral water and other nutrition food for medical insurance cardholders.

By the end of this March, the city's medical insurance fund scheme had included about 2.4 million people and 528 designated hospitals and drugstores.

About 255.9 million yuan (US$30.9 million) of the fund had been misused and recovered in the past three years.

"If the fund is not appropriately used, the insurance holders cannot benefit from it when they really need it," said Yuan Jianyong, the bureau's vice director general.

Nineteen supervisors have been recruited to control the fraudulent use of medical insurance cards.

The city will disclose the service quality and fees of designated hospitals in local media beginning this year.

(Shenzhen Daily May 11, 2005)

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