Today the former chief therapist of the Konami Sports Club Kishiwada Orthopedic Clinic received notice from OsakaPrefecture and the Osaka Social Insurance Bureau that fraudulent claims for medical treatment expenses had been made with respect to services performed by a Judo therapist as outlined below and was ordered to cease handling of insurance receipts for Judo therapy treatment expenses.
| 1. Period in question |
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August 14 to August 18, 2006 (Summer 2006 Kansai Area Swimming Camp)
August 13 to August 17, 2007 (Summer 2007 Kansai Area Swimming Camp) |
| 2. Number of persons: 269 |
| 3. Amount: 1,343,426 yen |
| 4. Details |
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Persons who were not treated were listed in the therapy records as having been treated, and fraudulent claims were made for treatment expenses. |
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| 1. |
Despite participating in the August 2006 and August 2007 summer swimming camps, all participants were listed as having been treated at the clinic, and fraudulent claims were made based on those records.
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| 2. |
Despite the fact that no Judo therapist was present during the summer swimming camp, the records stated that treatment was provided, and fraudulent claims were made based on those records.
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We set up a special task force within the company to perform an independent investigation alongside the investigation that was performed by Osaka Prefecture and the Osaka Social Insurance Bureau in the aims of discovering the facts surrounding the former chief therapist’s claims for treatment expenses and determining the cause of the fraudulent claims.
Our investigation revealed the same facts, and we sincerely apologize for having received inappropriate payments from health insurance societies as a result of the above claims.
We have taken these facts to heart and will immediately implement the following measures:
| 1. |
For the time being, procedures for making claims for treatment expenses will be put on hold at the Kishiwada Orthopedic Clinic, and operations will be voluntarily suspended. However, arrangements will be made so that customers who are currently receiving treatment will be able to continue to do so without interruption during this time, and we will bear the cost of the portion normally claimed from the insurer. |
| 2. |
We will promptly perform the procedures for returning the amount of the fraudulent claims in accordance with instructions received from the Osaka Social Insurance Bureau and other competent authorities.
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| 3. |
We will perform a factual investigation of the procedures in place at the 24 orthopedic clinics we directly operate (including the Kishida Orthopedic Clinic) for claiming treatment expenses and will suspend such procedures until the investigation is complete. |
Please accept our deep apologies for the trouble we have caused the parties involved. We will continue our efforts to further strengthen our compliance system in order to prevent anything like this from happening in the future.
Thank you for your continued patronage.
(Reference)
"Handling of insurance receipts for Judo therapy treatment expenses” refers to situations where the Judo therapist receives the portion of treatment expenses to be paid by the patient directly from the patient and then claims the remaining amount from the insurer on behalf of the patient.
