Hospitals accused of excess NHI reimbursement involving da Vinci use

04/14/2019 08:59 PM
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CNA file photo
CNA file photo

Taipei, April 14 (CNA) Some hospitals in Taiwan have been accused of claiming excess reimbursement from the national health insurance system for medical expenses involving the use of the da Vinci surgical system.

The National Health Insurance Administration (NHIA) released a report Sunday indicating that some NHI-contracted hospitals have asked patients to pay their medical fees for the use of the da Vinci surgical system while also applying for NHI reimbursement, claiming laparoscopic surgery was performed instead.

The da Vinci system is an advanced surgical tool that enables doctors to operate with minimal invasiveness through a few small incisions using robotic-assisted technology.

While the use of the da Vinci system is not covered by the NHI system, laparoscopic surgery is. As a result, some hospitals are suspected of using this to claim excess reimbursement from the national insurance system.

The NHIA has recently found that some hospitals are suspected of collecting medical costs ranging from NT$180,000 (US$5,833)-NT$200,000 for the use of the robotic surgical system, while applying for reimbursements for such medical treatments, involving 7,810 cases.

Among the top five hospitals with the highest numbers of such controversial cases are Taipei Medical University Hospital, accounting for 2,144 cases, followed by China Medical University Hospital, Linkou Chang Gung Memorial Hospital, Taipei Medical University Shuang-Ho Hospital, and National Taiwan University Hospital, each with 400-650 cases.

If irregularities are found in the management of any of the hospitals, they could face a fine 10 times the amount of the reimbursements they have claimed or have their contracts with the NHI system suspended for up to one year, according to the NHIA.

(By Chang Ming-hsuan and Evelyn Kao)


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