The Ministry of Health and Welfare will crack down on false health insurance claims such as padding the number of hospitalization days and registering fake patients. After a two-year pause following COVID-19, it will resume its planned health insurance investigation this year and carry it out for three months starting in Aug.
The ministry said on the 13th that it will conduct the 2026 planned health insurance investigation targeting care institutions that fall under the "frequent false-claim types." The investigation will run from Aug. to Oct.
Those surveyed are: padding the number of hospitalization and visit days double-claiming by charging patients for non-covered items and then billing health insurance claiming expenses for services or prescriptions not provided inflating the number of medical procedures claiming expenses for treatment or dispensing by unqualified persons.
The planned investigation is an on-site inspection conducted in areas of the health insurance system that need operational improvement. It was suspended in 2024–2025 due to COVID-19 and resumed this year.
The ministry used the Health Insurance Review & Assessment Service (HIRA)'s improper-claim detection system to screen care institutions with a high likelihood of false claims. The target institutions were finalized after deliberation by the on-site investigation selection review committee.
If the investigation confirms false claims, the improperly paid amounts will be recovered, and...
Odisha Gajapati said the information shared by ISKCON about his attending the Rath Yatra in Berlin in 1991 was misleading and the SJTA will issue a detailed clarification on Monday. (Photo | Expres...