Chinese mental hospital hires people to impersonate patients to gain insurance benefits

Xiangyang City, Hubei Province, with a population of about 5 million people, has more than 20 psychiatric hospitals scattered throughout the city. This density is so dense that local people say that they are as popular as beef noodle shops. However, the explosion of those facilities does not stem from the actual need for mental health care but from a goal of siphoning off public health insurance funds.

Sheet Beijing News day 3/2 published investigative reports, exposing a large-scale fraud ring related to private psychiatric hospitals in Xiangyang and Yichang cities. This newspaper’s report is said to be the result of a months-long field infiltration campaign at two facilities, including Hong An Mental Hospital in Xiangyang and Khang Ninh Mental Hospital in Di Lang, Yichang.

Accordingly, hospitals often organize staff to go to rural areas to “hunt” for patients. They make attractive promises such as completely free hospital fees, living expenses and door-to-door transportation. Many poor families, believing in the “free” label, accidentally sent their loved ones to those disguised “concentration camps”.

In fact, the huge source of revenue that helps hospitals maintain “0 dong” services comes from falsifying medical records. The reporter who penetrated reality discovered that in a bill worth more than 12,000 yuan (42 million VND) for 90 days of treatment, the drug cost was only 500 yuan (nearly 1.9 million VND). More than 6,000 yuan was falsely claimed for “psychotherapy” or “behavior modification” services that were never performed. For each “patient”, the hospital pocketed about 130 yuan a day from the insurance fund. A simple calculation by industry employees shows that with 100 patients, a hospital can profit up to 6 million yuan a year.

According to the reporter’s investigation, the strangest thing at hospitals in Tuong Duong and Yichang is the presence of many “patients” who are completely awake. There are elderly people who come to the hospital to… retire because it is cheaper than a regular nursing home, others come in just to quit drinking or simply want to enjoy free meals.

In the male ward of a hospital, the only nurse was a patient diagnosed with “alcoholic psychosis”. This person admitted that he was not sick, that his hospitalization was just a formality to help the hospital withdraw insurance money, but in reality he was working to receive salary and accommodation. At Khang Ninh Di Lang Psychiatric Hospital, even the security guard completed the admission procedure. They only return to their hospital bed to “play the role of patient” whenever an inspection team from the Department of Health Insurance comes to check.

Behind the profit numbers lies the truth about abuse. Reporters recorded scenes of nurses slapping, kicking and beating patients with water pipes. Just because of an argument with staff, a patient was tied to the bed for a whole day and night. There were cases of people being tied up for up to three days for disobeying.

To retain patients, hospitals use every means to prevent discharge. The patient’s phone was confiscated and he was not allowed to contact his family. A patient stuck for 5 years said: “Here is no different from a prison.” Despair has even pushed some people to commit suicide when they realize they have no way back.

To bypass authorities, hospitals often conduct “fake discharge” procedures for long-term inpatients. On paperwork, patients were recorded as having left the hospital, but in reality they were hidden or disguised to continue to stay. Data shows that some patients have checked in and out of the hospital up to 6 times in 18 months even though they have never stepped out of the gate.

Communicate with the newspaper Beijing Newsmedical reform expert Tu Yucai (Shaanxi province) said that mental hospitals can easily profit from insurance partly because of the “inside no export, no foreign entry” operating model, making it very difficult for the community and society to monitor. Another reason, according to Mr. Tu, is due to the patient’s own lack of self-care ability and awareness of what is going on around them. “They cannot accurately assess whether they are actually receiving medical treatment or not,” he said.

After being posted, the incident caused outrage in Chinese public opinion with more than 66 million views on social networking platforms. Just a few hours after the report was published, the Xiangyang and Yichang authorities announced the implementation of general inspections throughout the city. In the official announcement, officials said they will strictly handle all individuals and organizations that commit acts of profiteering and mistreating patients according to the law.