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Report: Taiwan’s NHIA accuses hospitals of overbilling for da Vinci procedures

CREDIT: This post was originally published on this site

Taiwan NHIA

Taiwan’s National Health Insurance Administration has accused several hospitals of falsifying or inflating the number of surgeries performed using da Vinci robotic surgical platforms from Intuitive Surgical (NSDQ:ISRG), according to a report from the Taipei Times.

The agency called into question a total 7,810 insurance claims with a cost of more than approximately $11.3 million (NT $350 million), according to the report.

Data provided from Sunnyvale, Calif.-based Intuitive Surgical showed the number of surgeries performed using the system in Taiwan did not match numbers declared to the administration, NHIA deputy director-general Tsai Shu-ling told the Taipei Times.

The NHIA said that an analysis it performed also found abnormal declarations related to procedures performed with the da Vinci platform.

A total of 13,903 surgeries were performed between early 2015 and February of this year, according to the report.

The NHIA said that some hospitals were charging patients between $5,831 and $6,479 (NT $180,000-$200,000) out-of-pocket while also applying for reimbursement for the single type of surgery the NHI covers using the da Vinci, the Taipei Times reports.

“The cost for da Vinci surgery operations is paid out of pocket, so hospitals should not file repeat reports,” Shu-ling said, according to the report.

Of Taiwan’s 19 medical centers, 12 performed more than 200 surgeries per year with the da Vinci, according to the Taipei Times report. Five of those centers allegedly made abnormal declarations accounting for more than 20% of all surgeries performed in a year.

Approximately 41% of all abnormal cases related to the da Vinci were reported by urology and gynecology departments, according to the report.

Taipei Medical University Hospital had the most abnormal declarations, at 2,144, followed by China Medical University Hospital, Linkou Chang Gung Memorial Hospital, Taipei Medical University’s Shuang Ho Hospital and National Taiwan University Hospital, the Taipei Times reports.

The NHIA gave hospitals a single week to rectify the abnormal cases, adding that facilities that admit to wrongdoing will be asked to return NHI payments. Hospitals found to have falsified or inflated reports after an investigation could face fines 10 times the NHI-covered amount and suspensions for up to a year, according to the report.

Last month, Intuitive Surgical said that it won another indication for the FDA for its da Vinci SP robot-assisted surgery device.



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