Scams reveal loopholes in rural medical system(2)

FAKE INVOICES

Similar fraud scams, which experts say have been on the rise in recent years, have also been reported in rural areas in Hunan, Guizhou and Guangdong provinces and are spreading throughout the country.

In 2010, a local NRCMS managing center in Anhua County in central China's Hunan Province reported 35 cases of fraud using fake invoices to cheat money from the NRCMS.

One of the biggest obstacles to preventing fraud is that it is hard to determine whether invoices are genuine or not, according to police.

Wang Yuping, director of Yizhou's NRCMS managing center, said verification staff can only determine the genuineness of the invoices based on their experience, or by calling hospitals to verify the invoices. But the large number of participants enrolled in the NRCMS program means a huge workload for staff.

In the meantime, even double-checking via phone calls can be a big headache, as there can be evasion or delays on the hospital's side, making the verification process slow and cumbersome.

Adding to the mounting difficulties is the fact that some doctors act in collusion with those committing fraud, making it almost impossible to spot fakes among the numerous invoices.

INFORMATION-SHARING NETWORK URGED

As the amount of non-local medical treatment rises, experts have called on the government to establish a medical information-sharing network in the country to crack down on scams.

In October 2012, the National Health and Family Planning Commission, then the Ministry of Health, stressed the importance of speeding up creation of a national NRCMS information-sharing platform. One project would require 26 hospitals frequented by NRCMS participants in Beijing and six provinces to be connected via the platform.

The commission also urged other provinces and regions to quicken their pace in establishing similar platforms at the provincial level to achieve information sharing.

Such platforms will help various departments to check reimbursements, supervise NRCMS funds, and analyze and evaluate NRCMS-related information, said Wang Yuping of Yizhou's NRCMS managing center.

Wang said the information-sharing network will guarantee the safety of NRCMS funds, because it allows staff to check the authenticity of the invoices online. The information will also be put into the patients' credibility records.

Wang proposed that such networks should be built on the national level, because the reimbursement systems vary in different areas, and a national network will make the verification process easier.

In addition, China should issue standardized medical invoices, which would be more convenient to check and manage, said Zhou Xiaodong of Yizhou.

Zhou said the society should step up supervision of the NRCMS, and anyone who reports fraud cases to the public security bureau should be rewarded.

"We should call on rural residents to abide by the law so that their own money can be better protected," he said.