鍼灸・マッサージ治療院の不正請求

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接骨院(柔道整復師)だけの不正を取り上げるのは不公平なので、本日は鍼灸・マッサージ治療院の不正をとりあげます。

横浜市から5400万円を不正受給をしていたのは「横浜みなみ針灸(きゅう)マッサージ治療院」(横浜市南区)と「土屋針灸マッサージ」(同市中区)を経営する土屋勉院長(70)。この治療院はマッサージ師57人と運転手20人を抱え、利用者の自宅へのはり・きゅう・マッサージ師を派遣する、訪問治療をしていた。

手口は、市への申請書にあらかじめ利用者の署名をもらい、後から水増しした利用回数を記入していた。「施術回数に関係なく月額1000円」をうたい、利用者を集めていたとみられる。療養費の請求は市全体の3割を超えていたという。横浜市は過去の不正についても調べを進めるとしている。

2治療院は突然閉鎖され、従業院80人は全員が解雇された。給与の一部は未払いのまま。ちなみに、この治療院の従業院の半数近くは視覚障害者であり、再就職は困難とされる。

横浜市が不正受給を発表した8日後の、2008年1月26日に土屋院長は自殺、横浜みなみ針灸マッサージ治療院の開設者だった元妻(64)も、31日に病死した。

この事件には二つの不正があります。まず、料金がひと月定額1000円です。これは自由診療では問題ありません。保険診療だと患者から1割~3割もらい残りは7割~9割は市から請求することになっているからです。保険診療は患者負担の料金が決まっています。患者負担を少なくして客集めのようなことは保険診療ではNGです。もう一つは、治療日数の水増しです。おそらく日数水増しを、患者から大目に見てもらうために患者負担を少なくしたのかもしれません。水増ししても患者側は料金を払わないので損はしません。損をするのは市です。いや、保険料を払っている市民です。一部の人間の私腹を肥やすために真面目な市民のお金が流れていくのです。残念。

 

 

 


 

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このページは、honetsugimanが2009年10月24日 18:37に書いたブログ記事です。

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