Hundreds of visits to state hospitals made over several years to obtain medicines
Police on Friday arrested a 58-year-old man on suspicion of healthcare fraud that caused more than 1.2 million baht in damages to the National Health Security Office (NHSO).
The suspect, identified only as Sukho, was apprehended at a hospital in Ratchathewi district of Bangkok after Crime Suppression Division (CSD) investigators received a tip-off that he was about to make a hospital visit.
He was accused by the NHSO, which operates the universal health coverage scheme, of committing healthcare fraud for several years by seeking services that were not medically necessary.
The fraud was first detected in February 2020 when the NHSO reviewed the records of a patient who sought emergency treatment for chronic obstructive pulmonary disease (COPD) every few days at different state-run hospitals.
An investigation found that from 2010 to 2016, the same patient made 675 requests for emergency treatment for COPD and other illnesses at various hospitals in different provinces.
He was prescribed oral and inhaled medications to alleviate symptoms on most visits.
According to the NHSO, inhaled medication for COPD can be used 200 times per bottle or for 60 days, so the patient’s frequent visits were irregular.
Considering the market prices of inhaled medications, between 350 and 400 baht per bottle, the office suspected the person was committing fraud and reselling the medication.
The financial damage from the fraud committed from 2010 to 2016 was estimated at over 1.2 million baht.