A doctor in Lam Dong was arrested for profiteering more than 350 million VND from health insurance

On the afternoon of December 16, Lam Dong Provincial Police prosecuted and arrested LVN (born in 1990, living in Ward 7) and H.D.T (born in 1987, living in Ward 5, Da Lat City, working together at the Hospital). Lam Dong Provincial General Hospital) to investigate the crime of "Abuse of position and power to appropriate property".

The police conducted a search, read the decision to prosecute the accused and detained these two people at their workplace, Lam Dong Provincial General Hospital.

Previously, media reported that Lam Dong province social insurance refused to pay health insurance medical examination and treatment costs for the first 9 months of the year of 19 verified cases with an amount of more than 357 million VND.

In addition, this unit has also temporarily not paid health insurance medical examination and treatment costs for 34 other cases with an amount of more than 527 million VND to verify related medical examination and treatment records by LVN doctors. There are signs of falsifying records and appropriating insurance money at Lam Dong Provincial General Hospital.

According to the investigation, defendant N. is a specialist doctor 1, working at the Emergency Medical Department of Lam Dong Provincial General Hospital.

Doctor N. has worked at Lam Dong Provincial General Hospital from 2014 to present. During that time, he was facilitated by the unit to study Emergency Resuscitation in Ho Chi Minh City, then returned to work at the Department of Medical Examination and Emergency Medicine. Here, the defendant often started the plan by chatting with nurses accepting health insurance patients to get information.

In 2023, when he had patient data including health insurance card numbers and citizen identification numbers, the suspect gave patient information to nurses, asking for help receiving medicine. When asked why many patients did not come to the hospital, defendant N. said they were family members or acquaintances and asked to receive medicine first, while the patient would be examined later to save time.

Many patients who do not have a medical examination scheduled or do not come for examination still have Dr. N. legalize the procedure to receive medication replacement. Many patients are prescribed the same medication on the same day, even with prescriptions just minutes apart.

Some patients have no history of examination or treatment for diabetes, but this doctor prescribes subcutaneous insulin injections at doses exceeding professional regulations. With the medicine he received, N. gives it back to the patients when they need it, otherwise it will be sold.

Regarding the amount of medicine he received, the defendant said that when the patient needed it, he gave part of it, the rest was used and sold, profiting more than 350 million VND. In addition to the above 19 cases, the authorities clarified 34 other cases with an amount of nearly 530 million VND also related to defendant N..

The defendant H.Đ.T works at the Pharmacy Department of the above hospital. T. was investigated as an accomplice, assisting N..

After reviewing, the Provincial Social Insurance discovered 18 more similar cases, all examined and prescribed by N.. Provincial social insurance refused to pay health insurance medical examination and treatment costs for 19 cases with an amount of 357 million VND. Doctor N. has refunded the above profit.

34 other cases with medical examination and treatment records related to this doctor are also temporarily unpaid with the amount of 527 million VND, for further inspection and review.

According to Mr. Le Van Tien - Director of Lam Dong Provincial General Hospital, when receiving information that LVN showed signs of profiteering, he asked this doctor to explain, this person admitted his behavior. Before Dr. N. was arrested (December 16), the hospital temporarily suspended his medical examination and treatment. The head of the department and the nurses involved must also explain the incident. The hospital also reviewed the process to handle violators.

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