GEORGE TOWN: “Patients” in a fraudulent Social Security Organisation (Socso) claim scam allegedly run by a Penang cartel typically only receive 50% of the disability payments.
The doctor involved pockets RM10,000, while the balance of the money would be divided among a network of agents and runners who facilitate the fraudulent transactions, said a source.
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Those familiar with the investigation into the alleged falsifying of Socso disability claims said the most common diagnoses in these cases are anterior cruciate ligament (ACL) and slipped disc injuries.
“In some cases, the patients are not even injured.
“Initial investigations showed that the systematic manipulation of medical claims dates back to 2017,” said the source.
Three doctors and a woman were among 33 people remanded yesterday for falsifying Socso disability claims amounting to RM2.1mil since 2017.
The orthopaedic specialists, aged 36, 50 and 57, were remanded for two days by a Magistrate’s Court.
It is understood that two are from government hospitals in Bukit Mertajam and Seberang Jaya while the third is from a private hospital in Butterworth.
The others are 19 Sosco contributors, eight agents and three runners, aged between 26 and 60, who have been remanded for one to three days.
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They are mostly factory and port employees.
The 33 were arrested on Tuesday by the Malaysian Anti-Corruption Commission (MACC) to facilitate investigations under Section 18 of the MACC Act 2009 for the submission of false claims.
The offence carries a maximum sentence of 20 years’ jail and a fine of RM10,000 or five times the value of the false claims, whichever is higher, upon conviction.
Magistrate Nadratun Naim Mohd Saidi issued the remand order.
In response to the arrests, the Health Ministry said it would cooperate with the investigation and gave its assurance that no element of abuse of power would be tolerated.
“The ministry is aware of the arrests of three senior doctors by the MACC for alleged links with a cartel that falsifies Socso disability claims.
“We are always ready to provide full cooperation to the MACC regarding the arrests and emphasise that no element of abuse of power by the ministry’s staff would be tolerated.
“The ministry will not hesitate to take appropriate action to ensure the best level of public health services,” it said in a statement.
The arrests came after Penang senator Dr RA Lingeshwaran called on the government, particularly the Human Resources Ministry, to explain the alleged suspension of senior doctors handling Socso disability claims purportedly linked to a cartel in the state.
He had reportedly brought the matter up at the Dewan Negara on July 28, stating that the panel was suspended until further notice after Socso discovered the racket at a hospital in Penang.
In asking Socso for an update, Dr Lingeshwaran, who was former director of Hospital Sungai Bakap, said the cartel was believed to be lobbying for the suspended doctors to return to work at the same hospital.
He also claimed there were 683 fraudulent Socso withdrawals from 2018 to 2022 involving about RM43mil, of which 16 involved a certain doctor whose services were terminated after the activities were exposed.