Recently, the chaotic situation of Chinese hospitals cheating on medical insurance has been partially exposed by the authorities. Some hospitals have been providing gynecological treatments for men and conducting male reproductive system examinations for women.
On August 31, the Chinese National Medical Insurance Bureau revealed that many hospitals across the country have been falsely billing medical insurance funds by providing “gynecological treatments for male patients.” Some male patients have been claiming expenses for “hysteroscopy examinations,” “cervical cancer screenings,” and “cervical dilation procedures,” which fall under gynecological treatments. In certain hospitals, as many as 1,674 such examinations have been carried out in a year.
According to the official WeChat account of the National Medical Insurance Bureau, some of these irregularities involve medical institutions substituting procedures to deceive medical insurance. For instance, the San331 Hospital in Zhuzhou City, Hunan Province, substituted the self-paid item “painless gastroscopy anesthesia” costing 74 yuan with the class-B item “hysteroscopy anesthesia” costing 450 yuan for reimbursement.
Moreover, the People’s Hospital in Leiyang City, Hunan Province, conducted 1,674 such procedures within a year.
Simultaneously, dozens of hospitals have been found to conduct male reproductive system examinations for women.
The National Medical Insurance Bureau discovered that in some local hospitals, female patients were undergoing “male-specific” diagnostic tests and treatments such as “prostate MRI imaging” and “free prostate-specific antigen tests,” which are exclusively meant for male patients. The purpose of these fraudulent examinations was to overcharge and misuse medical insurance funds.
Among the “hospitals leading in providing male reproductive system treatments for women,” a total of 30 medical institutions nationwide have been exposed. Geographically, these medical institutions are spread across eight provinces including Zhejiang, Jiangsu, Liaoning, Heilongjiang, Shanghai, Jilin, Shandong, and Fujian. Notably, Zhejiang has ten exposed medical institutions, accounting for one-third of the total nationwide.
Topping the list is the First Affiliated Hospital of Wenzhou Medical University in Zhejiang, with a total of 1,263 settlements. This hospital is one of the first four comprehensive hospitals in Zhejiang to pass the Level-III evaluation, providing medical services to nearly 30 million people in the southern Zhejiang, northern Fujian, and eastern Jiangxi regions.
On a personnel level, a total of 30 “department doctors leading in prescribing male reproductive system treatments for women” have been exposed nationwide. These doctors are spread across five provinces, including Jiangsu, Shandong, Jilin, Hunan, and Heilongjiang. Among them, fifteen doctors are from medical institutions in Jiangsu, constituting half of the total exposed individuals.