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Along with getting the overcharged money back, the erring medical facilities could face a fine worth up to 10 times the amount of the overcharged money, NHSO secretary-general Winai Sawasdiworn said.

Winai cited a random survey in 2007 of 100 medical facilities that took in 3,000 cases of NHSO subscribers. That year alone, such overcharging was accounted for by 20 per cent, worth about Bt30 million, he said.

For example, an appendicitis was billed as a ruptured appendix which cost more to treat, he said. However, the same survey also found that 10 per cent of the medical facilities had reimbursed the medical expenses lower than the real cost, worth about Bt7 million in total, he added.

In 2007, about 1,000 medical facilities took in five million NHSO patients, for whom NHSO had set a Bt30 billion budget for their treatment.

He expressed the belief that the overcharging might have resulted from misunderstanding, mistake or recklessness because the patients' symptoms were reported in codes, of which there were more than 100,000.

Winai said that in the past 4-5 years the NHSO only issued warnings for such actions and got the overcharged money back. But from the fiscal year 2009 on, it would also impose a fine. For a one-time offender, the fine could be the same amount of the overcharged money, say, Bt10,000 in fine for the Bt10,000 overcharged money. For repeated offenders, the fine could be more, possibly up to 10 times of the overcharged money that will not exceed Bt100,000 at a time, according to Winai.

Meanwhile, Public Health Minister Chalerm Yoobamrung, in his capacity as NHSO board president, yesterday said that such practise had not directly affected the NHSO, but had affected other NHSO subscribers.

In a recent board meeting, NHSO agreed to warn medical facilities to refrain from overcharging, he said. A facility can appeal and eventually have the Medical Council of Thailand determine if it has a standard medical practice or not.