A court in Astana has sentenced the director of a private clinic and an employee of a national scientific center for embezzling 79 million tenge from the Mandatory Social Health Insurance (OSMS) system. The investigation was conducted by the Department of the Agency for Financial Monitoring in Astana, according to the website infohub.kz.
The court found that the director of the private clinic, Forte Clinic (Tumar), organized a scheme to artificially inflate the number of patients registered with the facility to obtain unjustified funding from the Social Health Insurance Fund. He enlisted the help of an employee of the National Scientific Center for Health Development, who used his official access to unlawfully approve fictitious patient registration applications.
As a result, over 15,000 citizens were registered with the clinic based on written applications, even though current regulations allow such registration only for a limited category of people. The scheme also included registering residents from other regions, minors without documents from legal representatives, and citizens who were outside Kazakhstan.
Furthermore, the clinic director gained control over medical workers' accounts in the Damu Med information system by linking them to the administration's phone numbers. Using this access, he entered fake records of medical services provided to the illegally registered patients, which served as the basis for receiving funding from the fund.
The state suffered damages exceeding 79 million tenge. The court found the defendants guilty: the clinic director was sentenced to five years in prison, and the employee of the National Scientific Center for Health Development received three years. The Agency for Financial Monitoring reported that the damages have been fully compensated. The verdict has entered into force.