Core Viewpoint - The article highlights the serious issue of healthcare fraud in Shanghai, particularly focusing on two private traditional Chinese medicine clinics that have defrauded the medical insurance system of over 12 million yuan through false diagnoses and treatments [3][4]. Group 1: Fraudulent Activities - A police investigation revealed that the Shanghai Yiyang Traditional Chinese Medicine Hospital had suspicious billing practices, with many patients showing frequent visits without actual treatment, indicating potential fraudulent activities [3][4]. - The investigation uncovered that staff members at the clinics were involved in swapping expensive medicinal herbs for cheaper alternatives, profiting from the difference while defrauding the insurance system [4]. Group 2: Criminal Organization Structure - The criminal organization involved clinic management and staff who coerced employees into conducting false diagnoses, while also collaborating with "scalpers" to bring in insured patients for fraudulent billing [4]. - The operation included a network of individuals who collected and resold medications illegally, creating a comprehensive illicit supply chain [8]. Group 3: Law Enforcement Actions - The police successfully dismantled a fraud ring, arresting 12 suspects and seizing over 1.2 million yuan worth of drugs [7][11]. - New regulations were introduced requiring pharmacies to scan drug traceability codes during sales to combat fraud, with penalties for non-compliance [12][13].