Insurance authorities will financially reward whistleblowers who identify healthcare scams as part of the ongoing fight against fraud, according to a circular released by the National Healthcare Security Administration and the Ministry of Finance.
If the activity was unknown to the local healthcare insurance department before the report, informants could receive a percentage of the amount involved in the fraud after it is proved, the circular said.
Rewards should not exceed 100,000 yuan ($14,480), it added.
The circular was made public on Dec 15 after being released earlier to provincial-level healthcare security administrations.
Members of the public can report fraudulent practices by operators of healthcare insurance funds, medical institutions and pharmacies and their employees, as well as by individual insurance subscribers, it said.
Fraudulent practices include fabricating medical services and documents, providing fake invoices to subscribers, faking of medical service invoices by subscribers, lending a healthcare security card to others or receiving medical services with another person’s card to profit from the fund.
Whistleblowers can use their names or make anonymous reports, but they must confirm their identity before they can collect any reward. Healthcare insurance authorities at various levels should protect the privacy of informants, the circular said.
The introduction of the regulation is the latest effort by healthcare authorities in a campaign to fight insurance fraud.
Last month, a China Central Television report accused two hospitals in Shenyang, Liaoning province, of fraudulent practices, including hospitalizing insurance subscribers after faking diagnoses to get insurance funds. Police detained at least 37 suspects after the report.