Nursing worker sentenced to prison for defrauding national health insurance

Tian Shengjie
A nursing worker has been sentenced to prison for skipping work nearly two hundred times by exploiting a bug in the attendance system, and for defrauding national health insurance.
Tian Shengjie

A nursing worker was sentenced to prison for obtaining property from the national health insurance through deception, after she skipped work nearly two hundred times in a one year, the Jing'an District's court announced on Monday.

The 55-year-old woman, surnamed Ji, is not the only defendant of the nursing organization she worked for.

It is a designated organization for Shanghai's long-term care insurance. About 90 percent of nursing expenses can be covered by the nursing care allowance system for disabled elders, said Ma Yewen, team leader of the district's procuratorate for elder-related cases.

The hearings of the other seven people were held recently by the court ahead of Monday's Chongyang Festival, or Double Ninth Festival and the Senior Citizens' Festival.

Ma said that every day, the defendants should provide nursing services for around nine elders, including helping them eat and take baths. In order to skip work, these people used a bug in the application and the compassion of old people to gain fake digital clock-in records and signed confirmation sheets.

The eight felons illegally gained money between 20,000 yuan (US$2,733) and 4,000 yuan. They faced eight to four months of imprisonment with probation, Ma said.

Ma said all losses of the national health insurance have been retrieved, and the investigation and rectification of relevant organizations and departments are underway.

On Monday's hearing, Ji pleaded guilty and admitted that her colleagues always shared such experiences during their leisure time.

Nursing worker sentenced to prison for defrauding national health insurance

Ma said the use of elderly people's medicare cards to defraud national medical insurance has also been spread among other criminals. Many district-level procuratorates, such as Jing'an, Hongkou and Yangpu, reported similar cases on Monday.

The procuratorates said the elder people can buy cheaper medicine by using their cards under the national medical insurance policy. Some people, including the relatives of senior citizens, medicine sellers and even old people themselves, sold the cheaper medicine and illegally pocketed the difference.

In a scam reported by the Yangpu District's procuratorate, an inmate collaborated with three old people and defrauded a total of over 500,000 yuan from medical security funds through their medicare cards between 2018 and 2021.

They faced a sentence of up to 10 and a half years with one-year of deprived political rights, to one year and a half with reprieve, it said.

Huang Jing, procurator of Hongkou's procuratorate, said the medical security fund is life-saving money for many people, especially senior citizens and disabled people. It is related to their right to life and health.

The local procuratorates said they will cooperate with the public security organs to follow up clues and urge the defendants to return illicit money, in order to recover the losses of the national medical security fund. The relevant legal education will be enhanced.

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