The Xinhua Street Community Health Service Station is located near West Fourth Ring Road South Road, Fengtai District, Beijing, with an eye-catching sign, but the glass door is locked, and a reminder sign is erected at the door, which says that the outpatient clinic is suspended.
It was a day in January 2024, and the door of this community health service station was full of people, and occasionally people came to the door to look at it, saying that they had come to get medicine and see a doctor, but they didn't expect it to be closed. A woman who lives nearby told China News Weekly that the service station has been closed for several years, "Now there is everything, some say that the boss owes money and runs away; Some say that this service station is privately contracted, and now private contracting is not allowed."
According to China News Weekly, this community hospital is indeed contracted by individuals, and the contractor is named Li Penghui, who was arrested on suspicion of fraud in July 2020. In addition to this community hospital, Li Penghui has also contracted seven other community hospitals in Beijing's Fengtai District.
On December 29, 2023, the Beijing No. 2 Intermediate People's Court (hereinafter referred to as the "Beijing No. 2 Intermediate People's Court") pronounced the verdict of the first instance: Li Penghui committed the crime of fraud and was sentenced to life imprisonment, and at the same time committed the crime of embezzlement, the crime of non-state functionary, and the crime of false invoicing, and the punishment for several crimes was concurrent, and it was decided to carry out the sentence of life imprisonment.
The court found out through trial that Li Penghui used eight community hospitals, including the Xinhua Street Community Health Service Station, which he had contracted, to conspire with others to defraud the state of more than 100 million yuan in medical insurance funds.
The Taipingqiao Community Health Service Center, which was contracted by Li Penghui, is now closed. Photographer Liu Xiangnan.
Defrauded more than 100 million yuan of medical insurance funds
Before the case, Li Penghui was a legal person of Beijing Jingminkang Investment Management Co., Ltd., hereinafter referred to as "Jingminkang Company"), and was detained by the Fengtai Branch of the Beijing Municipal Public Security Bureau on July 29, 2020, and was arrested on September 4 of the same year.
Also in the same case as Li Penghui were Fan Zongtang, Fan Wenyuan, and Li Peirong. Before the case, Fan Zongtang was the actual controller of Beijing Nengji Traditional Chinese Medicine Decoction Pieces, Fan Wenyuan was a supervisor of Nengji Company, and Li Peirong was the financial director of Jingminkang Company.
After the investigation of Li Penghui's case was concluded by the Fengtai Branch of the Beijing Municipal Public Security Bureau, it was transferred to the Fengtai District People's Procuratorate of Beijing Municipality for examination and prosecution, and the Fengtai District Procuratorate submitted the case to the Second Branch of the Beijing Municipal People's Procuratorate for examination and prosecution. In October 2021, the Second Branch of the Beijing Municipal People's Procuratorate filed a public prosecution with the Beijing Second Intermediate People's Court. With regard to the part of Li Penghui and others suspected of fraud, the procuratorial organs ascertained the following facts:
Between 2015 and 2020, Li Penghui, Fan Zongtang and other four people conspired to illegally obtain national medical insurance funds, and first instructed their employees Wang Mopeng and others (all handled in separate cases) to privately purchase raw materials of traditional Chinese medicine or purchase finished Chinese medicine decoction pieces to supply Nengji Company, and then Fan Zongtang and Fan Wenyuan instructed their employees Chen Xiangcheng and others (all handled in separate cases) to forge raw material test reports and production records, print drug batch numbers, paste Nengji logos, etc., and then directed ** 8 community health service stations (centers) controlled by Li Penghui, including the Xinhua Street Community Health Service Station, were then defrauded by these 8 community health service stations (centers) of the state medical insurance funds by declaring reimbursement payments1More than 200 million yuan.
The eight community hospitals contracted by Li Penghui are all designated institutions for medical insurance. Photographer Liu Xiangnan.
Between 2015 and 2020, Li Penghui and four others conspired to illegally obtain national medical insurance funds, and in the process of purchasing and selling traditional Chinese medicine decoction pieces from Nengji Company at eight community health service stations (centers) controlled by Li Penghui, they instructed their respective employees to issue two kinds of sales bills, conceal and falsely increase the actual purchase and sale of drugs, and declare reimbursement payments, defrauding the national medical insurance fund of more than 4,300 yuan.
The eight community hospitals contracted by Li Penghui are all located in Fengtai District, Beijing, including seven community health service stations in Xinhua Street, Zhenguo Temple, Liuliqiao Nanli, Chengnan Jiayuan, Fengti Times, Wangyuan, and Dichang New District, as well as the Taipingqiao Community Health Service Center.
Li Penghui was born in December 1973 and his household registration is in Huaibin County, Xinyang City, Henan Province. Li Penghui's father, Li Peiri, said that after graduating from high school, Li Penghui went to Shijiazhuang City to study medicine, and then went to Beijing to develop his career as a first-class doctor and open a clinic. Relevant legal documents show that Li Penghui has a college education.
According to Li Penghui's confession, in order to facilitate the management of the eight community hospitals he has contracted, he established Jingminkang Company in 2014. These 8 community hospitals are private non-enterprise units in nature, and are not allowed to engage in for-profit activities, and their surpluses are not allowed to share dividends, and they are all designated medical institutions for medical insurance. All of them have signed custody agreements with Jingminkang Company to entrust the management of human resources and property to Jingminkang Company.
According to the industrial and commercial information, Jingminkang Company has a registered capital of 20 million yuan and is an enterprise mainly engaged in business services, with Li Penghui holding 100% of the shares. At present, the company is still in existence, but it has been listed by the court as a restricted high-consumption enterprise.
In the Li Penghui case, the other defendant, Li Peirong, was Li Penghui's aunt and was born in 1963. Li Peiri said that he has a total of 9 brothers and sisters, and Li Peirong is the ninth. Li Peirong went to high school, worked as a women's director in his hometown, and later came to Beijing to take charge of finance at his nephew's company. Among the relatives of the Li family, Li Penghui's brother-in-law Wang Mopeng was arrested because of Li Penghui's case. Wang Mopeng works as a purchasing manager in Jingminkang Company.
Fan Zongtang, the actual controller of Nengji Company, is the No. 2 defendant, born in 1962, and his household registration is Bozhou, Anhui Province, which is the famous "pharmaceutical capital". The other defendant, Fan Wenyuan, is the son of Fan Zongtang. According to the industrial and commercial information, Nengji Company was established in 2013 with a registered capital of 20 million yuan and is an enterprise mainly engaged in pharmaceutical manufacturing. The company has now been renamed and has moved to a new location.
Data**) The original Nengji Company, located in Fangshan District, Beijing, has now been demolished.
Fan Zongtang's wife, Kang Huaying, said that their hometown is in the suburbs of Bozhou City, Anhui Province, and that at the end of 1985, Fan Zongtang came to Beijing to do business, running some clinics or hospitals to sell locally grown Chinese herbal medicines purchased in Bozhou to these clinics or hospitals. In 2008, Fan Zongtang rented land in Xiaoma Village, Qinglonghu Town, Fangshan District, Beijing, to build a factory for the production of Chinese herbal medicines, called Beijing Shenghuitang Traditional Chinese Medicine Decoction Pieces***In 2013, he rented another land in Xiaoma Village to build a new factory, that is, Nengji Company.
The so-called Chinese medicine decoction pieces refer to the traditional Chinese medicine that can be directly used in the clinical practice of Chinese medicine after being processed and processed according to the theory of Chinese medicine and the processing method of Chinese medicine. Fan Zongtang's family revealed that Nengji's Chinese medicinal materials were mainly purchased from Bozhou, Anhui Province, processed into traditional Chinese medicine, and then supplied to many hospitals in Beijing. By the time Fan Zongtang and his son were arrested, Nengji had more than 70 "customers" in Beijing, including more than 40 community hospitals.
Fan Zongtang and Kang Huaying have three sons, of which Fan Wenyuan was born in 1988 and is the second in line; The eldest is named Fan Jinghui, born in 1985, and was also arrested on the same day as Fan Zongtang and dealt with in a separate case. From 2018 to the occurrence of the case, Fan Jinghui served as the legal person of Nengji Company. Kang Huaying, who was responsible for the purchase of Chinese herbal medicines in Bozhou, was also arrested on the same day as Fan Zongtang and was not prosecuted.
"Special" Chinese herbs in pharmaceutical factories
Li Penghui's case was tried for four days at the Beijing Second Intermediate People's Court. According to the first-instance verdict rendered by the Beijing No. 2 Intermediate People's Court, the trial of Li Penghui and others for the crime of fraud involved the testimony of more than 40 witnesses.
Xu Hong, Li Penghui's cousin, testified that in July 2016, Li Penghui asked him to help out at Jingminkang, where he worked to distribute and transport goods at Nengji's pharmaceutical factory. Around July 2020, Li Penghui asked him to go to Anguo, Hebei Province with Wang Mopeng, who was in charge of procurement at Jingminkang Company, to buy Chinese herbal medicines, and they sent the purchased herbs to Nengji Pharmaceutical Factory for processing and labeling, and then distributed them to community health service stations.
Xu Hong said that the drugs they imported from Anguo were very low, and the ex-factory price was the same as the price of the drugs produced by Nengji Company, and his company could earn more from it. Moreover, the drugs that are imported are all drugs that can be reimbursed by medical insurance, and self-financed drugs are not entered, and these drugs are only sold to Jingminkang's own health service station.
A community hospital contracted by Li Penghui posted a notice about "Chinese medicine decoction pieces".
A number of employees who worked at Nengji Company had testified about falsifying Wang Mopeng's testing data for medicinal materials. In March 2014, Sun Yaquan, who went to work in the inspection team of the quality department of Nengji Company, said that Wang Mopeng's goods stored in Nengji Company have raw materials and finished products, and Wang's goods are different from those of Nengji Company, which are stored separately. He also revised the origin and quantity of raw materials on the inspection report, because some of the raw materials are better, more well-known, and more expensive. An employee also testified that in the process of purchasing and selling goods from Nengji Company, he found that Wang Mopeng's goods were relatively special, and other hospitals all purchased finished products from Nengji Company, but Wang Mopeng purchased the goods himself, stored and processed them in Nengji Company.
Fan Jinghui, who served as a legal person in Nengji Company, confessed that Nengji Company is mainly engaged in the production, processing, and sales of Chinese herbal medicines, and its business scope does not allow the purchase of finished Chinese medicine decoction pieces, and cannot distribute other brands of finished Chinese medicine decoction pieces. Most of the raw materials for Chinese medicinal materials in Nengji Company were collected by his mother, Kang Huaying's company, from the Bozhou Medicinal Materials Market in Anhui Province, and some of them were purchased from An Guojin in Hebei Province, which was purchased by Wang Mopeng on behalf of Li Penghui.
Most of the TCM decoction pieces in the eight community hospitals managed by Jingminkang are obtained from Nengji. Fan Jinghui said that Wang Mopeng would give Nengji a purchase plan, and Nengji would start processing raw materials according to the types of this plan. Wang Mopeng purchased finished products and Chinese herbal medicine raw materials from Anguo, which were stored separately in Nengji Company, and Wang Mopeng's finished products could directly enter the warehouse of Nengji Company because Fan Zongtang and Li Penghui had agreed before.
After Wang Mopeng's raw materials enter the Nengji Pharmaceutical Factory, the quality inspection department conducts quality inspection, and sometimes the quality inspection results will be unqualified. In this case, Fan Jinghui will ask the inspector to re-test and adjust the testing method until Wang Mopeng's drug test is qualified; If you really can't get by, Fan Jinghui will contact a third-party inspection agency. According to the confession of Fan Jinghui's younger brother Fan Wenyuan, it will basically be qualified by a third party.
Fan Jinghui confessed that during the testing process, he also asked the personnel of the quality inspection department to change the testing data. After the raw materials are processed, the employees in the production workshop will package Wang Mopeng's medicine and label it with the company's label. When Wang Mopeng entered the part of the finished product of Nengji Company, there was no test report of Chinese herbal medicine raw materials when he came, and Nengji Company helped to make a quality inspection report. In addition, it is necessary to write production records for the processing of Chinese herbal medicine raw materials into finished products, so he arranged for the staff of the production department to compile production records of Wang's medicinal supplements.
Chen Xiangcheng, who served as the person in charge of the supply and marketing department of Nengji Company, confessed that the quality of Wang Mopeng's goods was poor, and most of them were finished products, and that the goods with the trademark of Nengji Company must have a full set of production records, and Nengji Company would arrange for people to make fake production records, and the finished medicinal materials purchased by Wang Mopeng were directly packaged by the production department, and only a few needed to be packaged after simple processing, and the production batch number was compiled.
The witness alleged that it was a "circular insurance fraud".
In January 2024, China Newsweek visited eight community hospitals in Beijing's Fengtai District, which were contracted by Li Penghui, and all but two community health service stations in Liuliqiao Nanli and Fengti Times were still open. The Jiayuan Community Health Service Station on Majiapu Road no longer exists, and its original site now runs a car maintenance shop, which has been open for two years and still has two big red letters on the top of the store, according to a clerk.
Although most of them are closed, the layout of the time can still be seen from the remaining furnishings. Walking into the Liuliqiao Nanli and Fengti Times Community Health Service Stations, which are still being treated, you can see that these two community hospitals have specially set up "Chinese medicine pavilions", which promote traditional Chinese medicine experts and traditional Chinese medicine characteristics such as scraping, massage, acupuncture and massage. On one side of the Zhenguosi Community Health Service Station, there is only a Cantonese restaurant, and the community hospital has also set up a special "Zhenguosi Traditional Chinese Medicine Department", which is the same size as the words "Zhenguosi Community Health Service Station". Looking through the window glass of the Xinhua Street Community Health Service Station, you can see that the propaganda board has the slogan "Let you enjoy high-quality Chinese medicine services at your doorstep", and posts the introduction of several Chinese medicine experts and a notification material about the "adjustment of Chinese medicine decoction pieces".
An interior corner of a community hospital contracted by Li Penghui. This edition is photographed by reporter Liu Xiangnan.
According to Li Penghui's confession, the Chinese herbal medicines in the eight community hospitals he runs were mainly imported from the Nengji Company, and Fan Zongtang of the Nengji Company promised to give him rebates, and the money was first transferred to the account of Li Peirong, who was in charge of finance at the Jingminkang Company, and then Li Peirong gave him the money. Each health service station (center) is independently accounted for, and the accounts are settled with Nengji Company separately, and the Finance Department of Jingminkang Company is mainly responsible for supervising these health service stations (centers).
Fan Zongtang confessed that he was introduced to Li Penghui, and Li Penghui told him that several of his community health service stations had purchased traditional Chinese medicine decoction pieces from the Nengji Company, and that they had asked for a large amount and offered a lower price, and that Li Penghui had agreed with him that after the supply of goods was completed, he would take 15 to 20 percent of the transaction amount as rebates. In addition, Li Penghui himself bought some Chinese herbal medicines and sold them to the Nengji Company, and Li made some more money, and after the Nengji Company processed them, he sold them to Li Penghui's community health service stations, because the medicines Li Penghui himself bought were of low quality, so these medicines could only be sold to Li Penghui's own community health service stations.
In the eyes of Fan Wenyuan, the son of Fan Zongtang, the cooperation they had with Li Penghui at the beginning was to make money, and they felt that it was a bit illegal and risky, but they did not realize that there would be such serious consequences, so they worked until the case was discovered.
Fan Wenyuan confessed that from the sales receipts, it is possible to distinguish between Nengji Company's own drugs and Wang Mopeng's own drugs: first, the varieties are different, there are many kinds of drugs purchased from Nengji Company, but the number of each variety is small, and Wang Mopeng's self-purchased and processed drugs are few, but the quantity is larger; Second, from the point of view of the deduction rate, Nengji Company's own medicine issued two tickets, one with the deduction rate was actually used to settle the bill with Wang Mopeng, and the other was without the deduction rate, which was used to settle the bill with the community health service station. There must have been two kinds of bills in the accounts of Nengji Company, one part of which was sold to eight community health service stations at a low price, and the other part was the bill for Li Penghui's own purchase of medicines.
In the later judgment, the court found that it was a method of conspiration between Li Penghui and Fan Zongtang to defraud medical insurance. In this regard, Fan Jinghui also mentioned it in his confession. According to Fan Jinghui's confession, Wang Mopeng ordered goods from Nengji Company to be shipped out of the warehouse, and according to the order plan, priority was given to stocking from Wang Mopeng's own goods stored in Nengji Company, and drugs that were not enough or not were stocked from Nengji Company's own finished goods. The billing room of Nengji Company will issue a companion bill with the goods respectively, among which Wang Mopeng's own goods with the goods will be sent away directly with the goods, and the accompanying goods of Nengji Company's own goods will be issued by the people in the billing room first, and then according to the lower ** with the goods finalized by Fan Zongtang and others. This kind of change in unit price to issue high and low bills has been happening since the end of 2017. The total amount of the ** ticket minus the total amount of the low-cost ticket is the profit of Li Penghui's eight health service stations from the Nengji Company, and they settle the bill according to the ** ticket.
Dong Mengmeng, who used to make a cashier at the Jingminkang Company, testified and recalled that there were two kinds of Chinese herbal medicines used in the various community health service stations controlled by Li Penghui, one was Nengji wholesale, and the other was Wang Mopeng wholesale, also known as self-use wholesale. The private purchase of Chinese herbal medicine was communicated privately between Li Penghui and the boss of Nengji Company, and the profit was maximized by reducing the cost of buying medicine and raising the cost of buying medicine. There is a difference between Nengji wholesale and self-use wholesale in terms of the quality of drugs and the way they are registered. Nengji wholesale belongs to the medicinal materials of regular pharmaceutical factories, and the wholesale for personal use is the medicinal materials that Wang Mopeng bought from outside, and the quality is not good. Dong Mengmeng said that Wang Mopeng bought low-cost drugs to Nengji Company, and then used Nengji Company's trademark to sell them to various community health service stations in accordance with national standards, and each community health service station used the medical insurance ** of the public account to buy.
Looking at Li Penghui's case, in addition to Dong Mengmeng, Zhang Hengxing, an accountant of Jingminkang Company, was directly mentioned in the testimony of the medical insurance. Zhang Hengxing testified: "The service station paid Nengji Company in accordance with the accounting standards, using the medical insurance funds in the service station's corporate account, and Nengji Company returned the wholesale money for its own use to Li Penghui and his designated personal account, and then Li Peirong withdrew the money and gave it to Wang Mopeng to let him go to Anguo to continue to buy cheap Chinese herbal medicines." ”
It's like this," Zhang Hengxing said, "This is a kind of deception, and it is the money of medical insurance." ”
First-instance verdict: The principal offender was sentenced to life imprisonment
Community health service stations are an important part of the management of public health services in society and play an important role in China's health services, but there are also problems that break out from time to time. In October 2021, the Supreme People's Court notified seven typical cases of punishing the crime of medical insurance fraud in accordance with the law, one of which was a community health service station in Beijing that defrauded the national medical insurance fund of more than 3,000 yuan by falsely prescribing drugs and other means, and its legal person was sentenced to life imprisonment.
Regarding Li Penghui's case, "China News Weekly" learned that it was the national medical insurance department that received a report and complaint, and then transferred the clue that "eight community health service stations were suspected of colluding with ** business to issue false invoices and defraud medical insurance" to the Beijing medical insurance department, and the case was discovered.
According to the first-instance verdict, the Beijing Municipal Medical Security Bureau issued a reply letter to prove that the actual amount of Chinese herbal medicine medical insurance** paid by the eight community hospitals involved in the Li Penghui case from January 2015 to April 2020 (including the Wangyuan Community Health Service Station since May 2019) was 24241957012 yuan, accounting for 81 of the total amount of all medical insurance transactions including Chinese herbal medicine project fees28%。The judicial audit report and the basic audit materials on which it is based prove that from January 2015 to October 2019, the total amount of the amount of traditional Chinese medicine decoction pieces purchased by the 8 community health service stations involved in the case from Nengji Company was 12495104569 yuan, the total amount of Nengji wholesale is 90643353 yuan, and the total amount of Nengji delivery is 469081333 yuan; The amount of payment related to the self-collection of Chinese herbal medicines by the 8 community health service stations involved in the case was 5598101384 yuan.
During the trial, Li Penghui did not recognize the alleged crimes, and for the crime of fraud, he argued that the raw materials of traditional Chinese medicine purchased by himself were low, and they were processed and supplied to community hospitals by Nengji Company, and the price of the drugs was also reasonable, and there was no false increase; He has never conspired with Fan Zongtang to use high and low fares to defraud medical insurance**. His defender issued a defense opinion, arguing that Li's self-collection of medicinal materials is a commercial business behavior, low-price procurement and sales are also a market operation behavior, and no quality problems have been found in the above-mentioned medicinal materials, and the sales of each link are in line with the law and the market; With regard to the part of Nengji Company's supply of medicines, the procurement, sales, and declaration processes of the health service station were all legal, and the difference between the high and low tickets was actually a rebate; in the two models, Li Penghui did not carry out fraud such as fabricating facts, concealing the truth, maliciously colluding, and inflating drugs, and the Medical Insurance Bureau did not have a wrong understanding, and Li Penghui did not constitute the crime of fraud.
With regard to the fraud crimes of Li Penghui and others, the court held that: objectively, Li Penghui, Fan Zongtang, and others carried out acts of fabricating facts and concealing the truth; The evidence in the case can prove that the defendants worked together to fabricate the actual purchase price of Chinese medicine decoction pieces, conceal the true basic data of the declaration, and defraud medical insurance funds; On the subjective side, the defendants had the intent to defraud and the purpose of illegal possession; The defense and defense opinions that the relevant defendants did not constitute the crime of fraud could not be sustained, and the court did not accept them.
On December 29, 2023, the Beijing Second Intermediate People's Court announced the verdict: Li Penghui committed the crimes of fraud, embezzlement, non-state functionary, and false invoicing, and decided to carry out a life sentence and confiscate all personal property; Fan Zongtang committed the crimes of fraud and offering bribes to non-state functionaries, and was sentenced to 15 years in prison; Li Peirong committed the crimes of fraud and embezzlement, and was sentenced to 15 years in prison; Fan Wenyuan was convicted of fraud, offering bribes to non-state functionaries, and forging the seal of the armed forces, and was sentenced to 12 years in prison.
China News Weekly learned that many people from Nengji Company, including Fan Jinghui and Wang Mopeng, as well as Jingminkang Company, were dealt with in separate cases, among which Fan Jinghui was sentenced to four and a half years in prison, Wang Mopeng was sentenced to five years in prison, and Chen Xiangcheng, who was in charge of the supply and marketing department of Nengji Company, was sentenced to seven years in prison. Fan Zongtang's father and son, as well as Li Penghui, were dissatisfied with the verdict and appealed.
Xu Hong, Sun Yaquan, Dong Mengmeng, and Zhang Hengxing are pseudonyms in the article).
Issued in 20242.5. The 1128th issue of China News Weekly.