4 sister hospitals have also been fined.

Written by Yao Yue Gao Yuanshan

Editor丨Wu Lijuan

Source: Bronco Finance

Falsification, falsification, destruction of medical records, and insurance fraud...... Wuxi Hongqiao Hospital, which was reported by real name and entered the public eye, was finally punished.

According to the information on the Credit China website, Wuxi Hongqiao Hospital was recently fined more than 58.95 million yuan by the Wuxi Medical Security Bureau. Subsequently, the practice license of medical institutions was revoked by the Wuxi Municipal Health Commission, and the Wuxi Municipal Health Commission issued a cancellation announcement on the official website of the Wuxi Municipal Government.

According to the administrative penalty decision, the facts of Wuxi Hongqiao Hospital's violation are: "From January 1, 2022 to September 22, 2024, there were false medical treatments, forgery and alteration of information, and fictitious medical service items. "The penalty decision date is October 28, 2024.

In late September, the news that "a CT film set multiple medical records, and the doctor reported the hospital in real name for suspected insurance fraud" pushed Wuxi Hongqiao Hospital to the center of public opinion. Subsequently, Wuxi Hongqiao Hospital deleted and blocked information to resist the inspection of the National Health Insurance Bureau, which made suspicions arousal.

On October 8, the National Health Insurance Administration issued the "Notice on the Unannounced Inspection of Wuxi Hongqiao Hospital in Jiangsu Province" (hereinafter referred to as the "Circular"), stating that Wuxi Hongqiao Hospital was suspected of using 22.284 million yuan of medical insurance funds in violation of laws and regulations, including colluding with intermediaries or in the name of free physical examinations, soliciting and inducing insured persons to be falsely hospitalized, and suspected of fraudulently defrauding the medical insurance fund of 11.792 million yuan through forged medical documents and fictitious diagnosis and treatment services(The final amount is subject to actual verification).

The local public security organs have taken criminal coercive measures against 24 criminal suspects, including the legal representative, the president, the intermediary who introduced fake patients, and the medical staff involved in the insurance fraud, and have launched an investigation into illegal acts such as collective collusion, destruction of financial documents, tampering with medical records, and deletion of data.

The "whistleblower" of Wuxi Hongqiao Hospital's insurance fraud incident was Zhu Chenggang, a radiographer at the hospital. Zhu Chenggang found that from 2023 onwards, there were some medical records in his department that had not done imaging examinations in the department, but had made a diagnosis based on the imaging, and he suspected that Wuxi Hongqiao Hospital was suspected of falsifying medical records and defrauding medical insurance, so he reported to the media with his real name.

According to the "surging news" report, Zhu Chenggang said that after the incident was exposed, he was under a lot of pressure, including complaints from hospital employees and blame from hospital suppliers. However, Zhu Chenggang also said that before reporting with his real name, he also considered the consequences clearly. After the incident attracted attention, the relevant departments also took necessary protection for it. Zhu Chenggang said that he is now considering leaving Wuxi temporarily.

Regarding Zhu Chenggang's "whistle-blowing" behavior and the pressure he is currently under, many netizens praised his courage and called for the protection of the "whistleblower". "I admire Dr. Zhu's courage, how much pressure he has to face, there are too few such people." "Protect Dr. Zhu" "Society needs such brave people as public supervisors. ”…… On social platforms, netizens commented.

It is worth mentioning that previously, Kunshan Hongqiao Hospital, the "brother hospital" of Wuxi Hongqiao Hospital, also had a special investigation team stationed, and the focus was to investigate whether there was image fraud and insurance fraud.

Behind Wuxi Hongqiao Hospital and Kunshan Hongqiao Hospital are the same actual controller, Wang Weimin, and the same largest shareholder, Media Group.

The founder of Medea Group is Chen Guoxing of the "Putian family" Chen family, but Chen Guoxing has fully withdrawn from Medea Group since the end of 2020. Today, Medea Group has gotten rid of the "Putian system" from the perspective of shareholders, but in fact, the "new head" Wang Weimin has been involved with three of the four major families of the "Putian family".

According to the above-mentioned "Circular", as the legal representative of Wuxi Hongqiao Hospital, Wang Weimin has been taken criminal compulsory measures by the public security organs in accordance with the law. So far, he has been at the helm of the Medea Group for less than 4 years.

　　01

Wuxi Hongqiao Hospital's insurance fraud was exposed

According to the administrative penalty decision on October 29, 2024, the Wuxi Municipal Health Commission received a letter of transfer of suspected criminal cases handed over by the Wuxi Municipal Medical Insurance Bureau to the Wuxi Municipal Public Security Bureau, Xi Medical Insurance Case Transfer Zi (2024) No. 02, which stated that Wuxi Hongqiao Hospital Co., Ltd. repeatedly used MRI, CT and other images to defraud the medical insurance fund. After investigation, the unit defrauded the medical security fund by forging medical documents. As a result, Wuxi Hongqiao Hospital Co., Ltd. was revoked from its medical institution practice license.

According to the content of the previous "Circular", the entire insurance fraud crime of Wuxi Hongqiao Hospital presents the characteristics of organized gang crime, professional fraud in the whole chain, the setting of yin and yang account books, real and false wards, and piecework commissions for the personnel involved.

During the entire process of committing the crime, Wang Weimin, the legal representative and actual controller of Wuxi Hongqiao Hospital, colluded with Hu Yuzhi, the president, and Tao Yanna, the head of the Wuxi Cancer Rehabilitation Association, and others.

In the specific process of committing the crime, Tao Yanna took advantage of her work convenience to introduce patients and the elderly to false hospitalization in the name of "preferential treatment" in Wuxi Hongqiao Hospital. Wang Guimin of the medical insurance information department of the hospital is responsible for docking, contacting the doctor to issue admission procedures, and handing it over to the head nurse to arrange "hospitalization".

After receiving the false hospitalization information, the clinician will "tailor" the false hospitalization plan according to the patient's personal condition. Hospital internal medicine, surgery, and orthopedic surgeons compile diagnoses of chronic diseases such as diabetes and lumbar disc herniation, and issue false medical orders, issue false prescriptions, and fabricate treatment records based on them.

According to the doctor's diagnosis, the physical examination center, radiology department, ultrasound department, laboratory department, etc., directly copy and intercept the image pictures of other patients corresponding to the diagnosis from the ultrasound and other image report databases, manually modify the report values, and forge the corresponding CT, MRI, ultrasound, blood and urine test and other report records.

In addition to individual physical examinations, most of the false hospitalization insured persons do not do any examination, diagnosis and treatment, and are discharged from the hospital after 2-3 days of free food and accommodation.

These fake inpatients are also placed separately from normal inpatients, using different ward codes to distinguish them, restricting the area of movement of fake patients, and controlling the scope of knowledge of personnel. According to the confession of the doctors at Wuxi Hongqiao Hospital, even the doctors of the hospital did not know that the hospitalization information of these patients was registered in their own department.

Source: Canned Gallery

The person involved in the case was a piecework commission, and a false hospitalization fabricated expenses of 5,000-8,000 yuan for one time, which was used to defraud the medical insurance fund. The personnel involved in the counterfeiting receive a commission from it, and the intermediary will receive 50 yuan for each person introduced; 200-300 yuan for each "hospitalization" of the insured person; The doctor in charge of false diagnosis and treatment will receive 50-80 yuan per order, and other medical staff will receive 15 yuan for each examination and test report fabricated.

In response to the commission of those who participated in the false hospitalization, the hospital also set up a yin and yang account book accordingly. The finance department of the hospital paid commissions to those who participated in the false hospitalization in the form of white slip exemption or cash payment, and the fund transactions were recorded in private account books, and covered up through forged accounting vouchers in the open account books.

On September 23, the National Health Insurance Administration sent an unannounced inspection team to Wuxi Hongqiao Hospital, and in the process of grasping the above situation, the National Health Insurance Bureau also encountered malicious confrontation investigations.

"The court has adopted multiple confrontational methods in a vain attempt to respond to the investigation with 'no evidence of death'." The National Health Insurance Administration said in the "Circular" that the staff of Wuxi Hongqiao Hospital maliciously resisted the investigation through collective collusion, tampering with medical records, destroying account books, and deleting data.

However, the relevant personnel attempted to destroy the inspection materials and accounting documents, but they were all seized by the public security organs; A large number of CT and MRI images were deleted, the computer host information of financial supervisors was deleted, and the electronic records of drug consumables procurement and sales were tampered with, which were later restored by the medical insurance department and the public security organs.

Previously, according to the "surging news" report, in 2023, Wuxi Hongqiao Hospital will use the medical insurance fund to settle 130 million yuan.

In this regard, the China Association of Non-public Medical Institutions issued a statement saying that Wuxi Hongqiao Hospital's bad behavior of insurance fraud has seriously ruined the reputation of the non-public medical industry, and the association requires all member units to severely condemn and jointly condemn this behavior, and report similar incidents and clues to the association and other relevant departments in a timely manner.

Bai Wenxi, vice chairman of the China Enterprise Capital Alliance, said that even if the amount of insurance fraud involved is not necessarily large, this behavior has seriously damaged the safety of the medical insurance fund, infringed on the public interest, undermined the integrity system of the medical industry, and caused serious adverse effects on the society.

　　02

Four sister hospitals have also been fined

Among the "Medea" hospitals, Wuxi Hongqiao Hospital is not alone, and its four brother hospitals have also been fined.

According to Tianyancha, the actual controller of Wuxi Hongqiao Hospital is Wang Weimin, who directly and indirectly holds a total of 42% of the shares; Medea Group, the largest shareholder, directly holds 40% of the shares; Wang Weimin is also the actual controller of Medea Group, directly holding 80% of the shares.

Source: Tianyancha

The insurance fraud incident of Wuxi Hongqiao Hospital has attracted the attention of regulators to its brother hospital, Kunshan Hongqiao Hospital. The actual controller of Kunshan Hongqiao Hospital is also Wang Weimin, who directly and indirectly holds a total of 41.2% of the shares; The largest shareholder is also Medea Group, with a direct stake of 39%.

According to the "People's Daily Online" Jiangsu, on September 22, the investigation team led by the Jiangsu Provincial Medical Insurance Bureau has been stationed in Kunshan Hongqiao Hospital, focusing on investigating whether the hospital has similar problems of image fraud and insurance fraud in Wuxi Hongqiao Hospital. The staff of the investigation team are already collecting and checking the hospital's archives and image records, and checking the catalog, CT number, registration number and other information.

In the eyes of the outside world, it is not surprising that Kunshan Hongqiao Hospital was investigated. Recently, Kunshan Hongqiao Hospital was exposed to "require patients to spend up to 7,000 yuan". In August, a screenshot of the group chat of the "HQ Doctor Group" posted by a netizen showed that a person named Chen Moumou sent a message, "If the monomer is less than 7,000 this month, don't do it." ”

Source: "CCTV" report

Because of this incident, Kunshan Hongqiao Hospital was quickly placed on file for investigation. The investigation results showed that the hospital was suspected of violating laws and regulations such as failing to comply with relevant diagnosis and treatment standards, failing to fill in medical records as required, and using antimicrobial drugs in an irregular manner. The administrative penalty in September showed that the hospital was fined 113,500 yuan.

In addition to Wuxi Hongqiao Hospital and Kunshan Hongqiao Hospital, Medea Group has also invested in 6 other hospitals - Shenzhen Ganglong Hospital, holding 47.01% of the shares; Hangzhou Tianmushan Hospital Co., Ltd., holding 45.5%; Wenzhou Jianguo Hospital Co., Ltd., holding 40.95%; Shanghai Jianqiao Hospital Co., Ltd., holding 40.95%; Shanghai Minhang Hongqiao Hospital Co., Ltd., holding 40.95%; Shenzhen Jianguo Urology Hospital, holding 0.01%.

Among the 6 hospitals, in addition to Shenzhen Jianguo Urology Hospital, the actual controller of the other 5 hospitals is also Wang Weimin. Among them, two hospitals have been involved in the use of medical insurance funds and have been subject to administrative penalties.

In December 2023, Shanghai Jianqiao Hospital was fined 6,315 yuan for violating the diagnosis and treatment norms, excessive inspections, repeated charges, etc., which caused losses to the medical security fund; In June 2023, he was fined 1,500 yuan for violating the relevant provisions of the "Regulations on the Supervision and Administration of the Use of Medical Security Funds"; In November 2022, he was fined 3,200 yuan for repeated charges, excessive standard charges, and exceeding the medical insurance payment limit.

Source: Tianyancha

Wenzhou Jianguo Hospital was fined 956,000 yuan in February 2022 because between May 1, 2021 and June 30, 2021, medical staff carried out repeated charges, decomposed project charges, excessive standard charges, and included medical expenses that are not covered by the medical security fund into the settlement of the medical security fund due to misunderstanding and negligence, resulting in a loss of 470,000 yuan in the amount of medical insurance.

In addition, in January, Shenzhen Ganglong Hospital was also fined for failing to implement the verification system for obstetric nurses, resulting in pregnant women fraudulently obtaining birth certificates for their babies.

　　03

The new head has something to do with the three major families of the "Putian family

The founder of Medea Group is Chen Guoxing of the Chen family of the "Putian family". In 2002, Chen Guoxing registered the first hospital in Shanghai, Shanghai Minhang Hongqiao Hospital, and officially entered the hospital, and then established Shanghai Jianqiao Hospital and Wuxi Hongqiao Hospital. In 2003, Chen Guoxing founded Medea Medical Group. Based on Medea, the "Medea Department" hospital was established.

In 2009, Chen Guoxing entered the more profitable medical aesthetic industry and founded Yixing Medical Aesthetics, which has now become Chen Guoxing's core industry. In 2018, Yixing Medical Aesthetics submitted a listing application to the Hong Kong Stock Exchange. According to the "Prospectus", in 2017, the revenue of Yixing Medical Aesthetics reached 1.037 billion yuan, and the net profit was 114 million yuan. However, the listing of Yixing Medical Aesthetics failed.

It is worth mentioning that in 2004, the second year of the establishment of Media Group, Media Group and a number of companies jointly funded the establishment of Medicilon (688202. SH）。 In 2019, Medicilon was listed on the A-share market. At present, Chen Guoxing is the sixth largest shareholder of Medicilon, holding 3.62% of the shares.

Source: Canned Gallery

Chen Guoxing's focus has long shifted to the medical aesthetic industry and the impact on the capital market, and in recent years, the survival challenges of private hospitals have become more and more great. According to the National Enterprise Bankruptcy and Reorganization Case Information Network, in the first quarter of 2024 alone, dozens of private hospitals will declare bankruptcy and liquidation, including many large-scale and high-end hospitals.

Yuan Shuai, the founding founder of the Xinzhipai New Quality Productivity Lounge, said that the bankruptcy and closure of private hospitals in recent years reflects the problem of oversupply and poor supply to a certain extent. The key to stimulating this clearance is the intensification of competition in the medical market, the strengthening of policy supervision, and the change in patients' medical choices. In the market competition, it is difficult for private hospitals with non-standard management, poor service quality and lack of core competitiveness to survive.

Chen Guoxing's brother Chen Guoxiong withdrew from the Medea Group in 2017, and when he exited, he transferred 32% of the shares to Chen Guoxing, and Chen Guoxing held 80% of the shares. In December 2020, Chen Guoxing transferred 80% of his shares to Wang Weimin, and Medea Group changed hands.

So far, Medea Group has gotten rid of the "Putian system" from its own shareholder level. However, among the four major families of the "Putian family" "Chen, Zhan, Lin, and Huang", the "new head" Wang Weimin has a relationship with the three families.

Before taking charge of the "Chen family" Medea Group, Wang Weimin had been intersecting with it for many years. According to Tianyancha, Wang Weimin held shares in Wuxi Hongqiao Hospital for the first time in 2009; In 2015, it held shares in Shenzhen Ganglong Hospital for the first time. In addition, Wang Weimin served as the executive director of Wuxi Hongqiao Hospital for the first time in 2005; In 2005, he served as a supervisor of Hangzhou Tianmushan Hospital for the first time; In 2015, he first served as a director of Shenzhen Ganglong Hospital and retired in 2018.

From 2017 to 2023, Wang Weimin served as a senior executive of Weilin Medical. In 2016, Zhan Zongyang, a member of the "Zhan family", was appointed as Weilin Medical Aesthetic Legal Person, and Weilin Medical Aesthetics immediately made rapid efforts in the medical beauty track, and in November of that year, Baidu searched for "medical beauty staging", and the first place was already Beijing Weilin Medical Aesthetic Hospital.

Wuxi Hemei Obstetrics and Gynecology Hospital, where Wang Weimin served as an executive, is affiliated with Hemei Medical, which was founded by Lin Yuming, the "Lin family". Hemei Medical was once the largest private gynecology and pediatric hospital group in China, but it has exploded in 2023.

After the rapid expansion, due to the rupture of the capital chain, the hospitals under Hemei Medical were closed down and cancelled one after another. In 2023, Beijing Baiziwan Hemei Women's and Children's Hospital was suddenly closed, and the inpatients were forced to transfer to the hospital, which aroused the attention of the outside world to Hemei Medical. At present, Lin Yuming has been listed as a dishonest person subject to execution.

Source: Tianyancha

The relationship between Media Group and the "Putian system" may not stop there.

"Yicai" once reported that a person familiar with the matter said that the management relationship within the Pu family, which is rooted in the clan and local relations, is often very complicated, and under the signboard of the same "** hospital", it may belong to father and son, uncle, cousin, or even more distant "more winding" relatives.

Among the shareholders of Medea Group's hospitals, there are also many people surnamed Lin and Zhan. For example, Lin Mingxiong and Lin Mingjie, the second largest shareholders of Wuxi Hongqiao Hospital; Zhan Jianguang behind the third largest shareholder.

In fact, after the "Wei Zexi Incident" in 2016, the "Putian Department" had a stronger sense of crisis and began to accelerate its transformation and listing.

Like the Chen family mentioned above, in 2019, Medicilon, which is mainly engaged in preclinical comprehensive biomedical R&D services CRO, was promoted to land on the Science and Technology Innovation Board. In the past five years, Medicilon has also successively invested in a number of medical technology and biomedical companies.

During this period, some of the member groups may be called successful in transformation. However, for the "Putian Department", which once accounted for 80% of the total number of private hospitals, in its long-term "barbaric" development process, those initial development ideas and behaviors spread in the industry through the way of "person-to-person", and it is not easy for the "Putian Department" to completely reverse its image.

"As long as there is one that has not departed from the original (promotion) model, we will never be able to take off the label on us." After the "Wei Zexi incident", a person in charge of a private hospital in Putian, who did not want to be named, once told "Yicai".

However, at present, although the industry is clearing out inferior supply, the national policy supports and encourages law-abiding and high-quality private hospitals. As early as the "National Medical and Health Service System Planning Outline (2021-2025)", the state mentioned "encouraging social capital to run medical services". In the eyes of industry insiders, accelerating the upgrading of quality and efficiency with the help of scientific and technological innovation and forming more "differentiated and specialized" services is the key for private hospitals to cope with the challenges of development in the new stage.

What other frauds and arbitrage chaos do you know? Feel free to leave a comment.

View original image 413K