Project News

The workshop on audit was held with a Japanese expert on 14 July 2021 online. Around 60 officials of the headquarters and regional offices of National Health Security Office (NHSO) joined to learn Japan's claims review and guidance and audit system and had lively questions and answers.

The auditing system of NHSO has steadily improved over time and is periodically re-aligned to match the changing mechanisms of disbursement. However, in 2020, annual audit and further investigations revealed enormous number of fraudulent claims by private facilities. For sound, viable, and efficient provision of quality services, it is required to further improve the audit system.

In the workshop, the participants eagerly learned Japan's mechanism of screening fraud cases in the claim review process, in which computerized check and human check mostly by the part-time medical specialists, who have vast experience at current medical settings, play critical roles. The importance of on-site inspection conducted by the Guidance and Audit Bureau of the Ministry of Health, Labour and Welfare was also highlighted. The participants were also interested in punishments against medical facilities which committed vicious fraud.

It was recognized that the tasks of claim and audit are quite practical hence such a sharing of knowledge and experience among the officials who have committed to this process must be useful.

During and after the workshop, the participants raised further issues that they eager to learn from Japan. Based on the requests, the project will continuously work together to improve the audit system of NHSO. The project is also planning knowledge sharing with other countries who are interested in claim and audit system of Thailand and Japan.