National Health Insurance Loopholes? Female Pharmacist Defrauds NT$56.22 Million, Gets Probation, Sparking Outrage

🟪Suspect: A 70-year-old female pharmacist in Kaohsiung, surnamed Hsu, and her husband, both licensed pharmacists, operated four chain pharmacies. 🟦Period of Offense: From 2008, for approximately 10 years. 🟪Method: Disguised chronic disease prescriptions as discounts for goods or gift certificates; if patients didn't pick up their medication with a prescription, she would calculate it at 70% of the drug cost and allow them to redeem it in-store. 🟦False Claims: Falsely recorded in the POS system that medications were dispensed and delivered, and monthly defrauded the National Health Insurance Administration (NHIA) for medication and pharmaceutical service fees. 🟪License Rental: The couple used their names for two pharmacies and rented out the licenses for the other two to others. During nighttime or weekend hours when no pharmacist was on duty, she assigned unlicensed employees to dispense medication or uploaded records under the names of pharmacists who were not on duty, to circumvent dispensing limits. 🟦Amount: Defrauded NHI fees totaling over NT$56.22 million over 10 years. 🟪Criminal First Instance: Convicted of fraud, Hsu was sentenced to 2 years, with a 5-year probation granted considering her age over 70. 🟦Criminal Second Instance: After the prosecution appealed, the Kaohsiung High Court acknowledged the NT$56.22 million fraud but noted that the NHIA had already offset NT$22.93 million and her properties were seized as collateral. The sentence was reduced to 1 year and 11 months, with a 5-year probation. Further appeal is possible. 🟪Civil Case: The NHIA filed for tort damages. The Kaohsiung High Court ruled that Hsu and the involved pharmacists were jointly liable, upholding the first-instance judgment and ordering them to pay NT$39.47 million in joint and several damages. Further appeal is possible. 🟦Significance: Prescriptions became tools for gift certificate discounts, highlighting loopholes in NHI claims and pharmacy dispensing management. Feels like the appeal will ultimately result in a light sentence and no jail time. After all, the higher-ups said it themselves, if you can pay the money, you don't have to go to jail 🙄