Police in Chiang Rai province have been requested by the National Health Security Office (NHSO) to investigate a clinic suspected of defrauding the universal healthcare system. The clinic is alleged to have serviced at least one fraudulent patient.
Doctor Attaporn Limpanyalert, deputy secretary-general of the NHSO, lodged a formal complaint at Ban Du Police Station in Wieng Pa Pao district. The clinic is accused of defrauding the agency of 1.8 million baht. The NHSO has not disclosed the clinic’s name but mentioned it was incorporated into the NHSO’s scheme in October 2023.
The NHSO initiated an investigation into the clinic after receiving a minimum of three complaints. In one instance, a patient could not access the universal healthcare programme because the system incorrectly showed them as registered at the implicated clinic.
Reports from the NHSO’s official LINE account indicated an unusually high number of patients were linked to the clinic. It was revealed that the clinic’s owner directed patients, who were meant to visit a hospital, to use the clinic’s services instead. The NHSO has not specified the hospital’s name or confirmed whether the clinic owner is a medical professional.
Additional information from the Wieng Pa Pao news Facebook page suggested the clinic collected identification cards from clients to falsely claim reimbursements. In return, clients were given items such as milk, shampoo, and toothpaste, reported Bangkok Post.
Dr Attaporn stated that preliminary investigations supported the validity of the complaints, justifying the NHSO’s decision to involve the police.
“The NHSO will expand the investigations to other clinics in the system if it finds unusual reimbursements.”
The NHSO runs the universal healthcare scheme, which is available to clinics and other health centres. Clinics serve as primary healthcare providers for patients registered under the universal coverage programme.
In 2020, the NHSO accused 18 community clinics in Bangkok of submitting false claims for reimbursements under the 30-baht healthcare scheme. The fraudulent activities involved altering patient health records to claim higher reimbursements, resulting in an estimated loss of 72 million baht. The investigation affected over 200,000 healthcare scheme members who had to find new clinics, according to Bangkok Post.
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