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September 22, 2017

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Drugstores probed over health insurance fraud

Almost three-dozen pharmacies are being investigated for allegedly having defrauded the National Health Insurance (NHI) program out of more than NT$70 million, government investigators said yesterday.

Agents from the Bureau of Investigation raided 35 pharmacies in Taipei, New Taipei, Taichung, Tainan and many other cities and counties, and questioned a total of 95 people, including the owners of the drugstores and licensed pharmacists, officials said.

These drugstores allegedly borrowed licenses from the pharmacists so that they could dispense NHI-prescribed drugs and claim service fees from the universal health program, the officials said.

Many of these drugstores are famous in their respective areas, the officials said, adding that one suspect from Central Taiwan was a former official of the National Pharmacists Association.

The bureau alleged that these illegal practices have defrauded the NHI of drug dispensing service fees since 2006.

The license lenders include civil servants, college teachers, researchers and employees of pharmaceutical firms, the bureau said, adding they allegedly received NT$80,000 to NT$120,000 a year for lending the licenses.

According to the NHI rules, each licensed pharmacist will receive service fees for a maximum of 100 daily. Pharmacists who do not personally dispense the drugs are not entitled to the service fees.

The rules are meant to make sure that patients receive personal services from licensed pharmacists, and that pharmacists will not overwork.

The officials said the pharmacies borrowed the licenses in order to beat the daily quotas.

The bureau said the suspects would be referred to their respective district prosecutors' offices for further investigation.

The raid involved almost 200 agents from the bureau and 11 field offices around the island, the officials said.

Nine of the 35 drugstores raided were described as having committed offenses of a much larger scale than the others.

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