A scandal has emerged in the capital's clinic as it has illegally claimed services for over 100 million tenge by falsely registering 16,000 citizens, stated the Social Health Insurance Fund. Legal proceedings have commenced.
The Social Health Insurance Fund revealed significant violations in the use of funds during a monitoring exercise. It was discovered that a private clinic in Astana illicitly registered around 16,000 citizens, over 13,000 of whom are children, without their knowledge or consent, in order to receive funding from the Fund.
According to the Fund, clinics receive a basic payment of 1617.64 tenge per month for each registered resident from the guaranteed free medical care fund. The clinic in question was receiving approximately 1800 tenge per attached individual per month from the government.
Individuals who had permanently or temporarily moved abroad, as well as residents of other regions of Kazakhstan, were falsely registered to this clinic. Complaints were lodged by individuals who had never visited the clinic but received messages about medical services, causing confusion and outrage.
Furthermore, aside from guaranteed payments, the clinic fraudulently billed for services not rendered for 16,000 citizens in the social health insurance system, resulting in what is known as "ghost billing". Shockingly, there were instances of medical services being billed for children who had passed away 5-10 years ago.
The clinic falsely claimed over 33,000 services, totaling more than 100 million tenge. The case has been escalated to law enforcement agencies, and a legal dispute between the Social Health Insurance Fund and the clinic is ongoing in the specialized economic court of Astana.
Earlier, the Minister of Health of Kazakhstan, Akmaral Alnazarova, disclosed numerous violations of financial discipline, embezzlement, and unjustified salary payments and bonuses within the social health insurance system during a session in the Mazhilis on March 18, 2024.
