Photo/Illutration The headquarters of Tokyo's Metropolitan Police Department (Asahi Shimbun file photo)

Tokyo police on Jan. 16 arrested seven men, including dentists, on suspicion of defrauding Nagoya city of dental fees through bogus reports and the health insurance cards of foreign students.

The suspects are accused of falsely claiming to have treated the foreign students at a dental clinic, creating bogus medical fee statements and illicitly obtaining about 20 million yen ($129,000) from the city in health insurance reimbursements from May to October 2023.

According to the Metropolitan Police Department’s international crime division, the suspects include: Yuki Fujiwara, 43, a company executive; Akira Oishi, 61, a dentist; Hirotaka Koyama, 34, a dentist; Akihiro Mizutani, 35, an employee of an organization; and a Nepalese national, 37, who worked at a Japanese language school in Aichi Prefecture.

Police said that in one instance in early June 2023, false medical fee statements were made at a dental clinic run by Koyama in Nagoya’s Nishi Ward.

The statements wrongly claimed the clinic had treated 62 foreign students, including Nepalese, and were submitted to a national health insurance organization.

Nagoya city and others then provided about 2.87 million yen in reimbursements to the clinic, police said.

In October 2024, four individuals, including Fujiwara and Oishi, were arrested and indicted on suspicion of fraud in a similar scheme. They pretended to have treated foreign students at a dental clinic in Tokyo’s Edogawa Ward and received reimbursements from fake medical fees reports.

Investigative sources said in the case that led to the latest arrests, the seven suspects each had specific roles in the scheme, which was led by Fujiwara and Oishi.

According to the sources, Fujiwara and others initially approached Mizutani, who ran a business that dispatched foreign nationals in Aichi Prefecture, and asked him to find students from Japanese language schools who could take free dental checkups.

Mizutani then asked an acquaintance, a Nepalese man working at a Japanese language school in Aichi Prefecture, to recruit foreign students.

Koyama and others were also asked to set up a clinic in Nagoya’s Nishi Ward as the “location” for the checkups.

In April 2022, 62 foreign students visited Koyama’s dental clinic for the free dental checkups. The suspects photographed these students’ national health insurance cards.

A man working at a company managed by Fujiwara then used the photographs to create medical fee statements listing services that were never offered to the students, the sources said.

The reports were then submitted to an insurance organization.

In general, medical institutions compile medical fee statements once a month, describing details of patient care, and send them to a certified national health insurance organization.

If there are no discrepancies in the name of the disease or the number of times the patient has been treated, the medical institution is reimbursed.

The number of medical fee statements submitted in Japan is quite large.

In Tokyo alone, 8 million to 9 million medical fee statements are submitted per month, according to the Tokyo Metropolitan National Health Insurance Organization.

This makes it difficult to confirm whether a doctor actually examined the patient, a metropolitan government official said.

Furthermore, it is even more difficult to uncover fraudulent claims involving foreign students, according to the investigative sources.

Usually, when a fraudulent or erroneous medical fee statement is discovered, the person whose insurance card was used learns about it through a medical expense notice sent to his or her home.

However, in this case, the insured were international students, and some of them only inquired at the language school about the strange notices they received.

(This article was written by Shomei Nagatsuma and Tabito Fukutomi.)