NHIS, Strict Punishment for 136 Workers Involved in Long-Term Care Fraud

▲National Health Insurance Service

[Asia Economy Reporter Cho Hyun-ui] Care worker A provided services only two days a week and claimed payment by scanning the home care benefit electronic management system (RFID: a system that transmits service provision time in real-time) tag at their own home for the remaining three days. A was found guilty of fraudulent claims through an on-site investigation and received a six-month service suspension and a fine of 1 million KRW.

The National Health Insurance Service announced on the 8th that it detected 136 workers involved in fraudulent claims like A through an on-site investigation jointly conducted with the Ministry of Health and Welfare.

The detected workers are prohibited from working in any long-term care institutions in all related occupations, not only the occupation they were in at the time of the suspension, for six months during the service suspension period. If they work during the suspension period, they may face penalties such as repayment of benefit costs.

The Service plans to actively investigate long-term care institutions with a high possibility of fraudulent claims, such as RFID fraudulent tagging and false personnel reporting.

In the future, a law will be implemented to restrict not only workers but also beneficiaries involved in fraudulent claims from receiving long-term care services for a certain period, and the system has been improved to allow anonymous reporting of fraudulent claims.

An official from the NHIS stated, "We will continue to prevent unnecessary financial leakage through administrative sanctions on long-term care fraudulent claims and strive to foster a sound and transparent culture of long-term care benefit cost claims."

This content was produced with the assistance of AI translation services.