Ministry of Health and Welfare publishes list of institutions that filed false national health insurance claims; names to remain posted for six months starting Thursday

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Case No. 1: Medical institution A inflated the number of X-rays it claimed to have taken and billed the national health insurance system for general radiological imaging fees it had not earned, fraudulently collecting 45.38 million won ($33,500) over 37 months. The Ministry of Health and Welfare ordered the institution to repay the unlawful gains, imposed a fine of 90.76 million won, published its name on the public list and referred it to prosecutors on charges of fraud under the Criminal Act.

Case No. 2: Medical institution B billed the national health insurance system for consultation fees, traditional Korean medical procedures and treatment fees over 17 months — claiming patients had visited in person when they had not — and collected 927.37 million won in fraudulent claims. The ministry ordered the institution to repay the unlawful gains, imposed a fine of 4.64 billion won, published its name on the public list and referred it to prosecutors on charges of fraud under the Criminal Act.

The Ministry of Health and Welfare said Thursday it would publish the names of 58 medical institutions and other healthcare providers that fraudulently billed the national health insurance system for benefit costs, posting the list on its website and other official channels for six months.

The 58 institutions named include two hospitals, 36 clinics, 10 dental clinics, eight traditional Korean medicine clinics and two pharmacies.

To qualify for public disclosure, an institution must have received an administrative sanction for fraudulent billing and either have filed false claims totaling 15 million won ($11,100) or more, or have had fraudulent claims account for at least 20 percent of its total billed amount. Each case was reviewed and confirmed by the Health Insurance Disclosure Review Committee.

Before being listed, each institution was notified in advance and given 20 days to submit a rebuttal. The committee then conducted a secondary review of any statements and supporting materials before finalizing the disclosure.

The published information includes the name, address and type of each institution, along with the representative's name and license number, the nature of the violation and the administrative sanction imposed.

The names will remain posted from Thursday through March 31, 2027 — a period of six months — on the websites of the Ministry of Health and Welfare, the Health Insurance Review and Assessment Service, the National Health Insurance Service, and the relevant local governments and public health centers.

Yoo Ju-heon, director general of the ministry's Health Insurance Policy Bureau, said the government would continue conducting on-site investigations of institutions suspected of fraudulent billing and would strictly enforce public disclosure alongside administrative sanctions. "We will work to raise awareness about fraudulent claims and ensure that national health insurance funds are not wasted," he said.


thlee@heraldcorp.com