Jiangxi fights hard to cheat insurance to recover 168 million yuan of medical insurance fund
Xinhua News Agency, Nanchang, November 17 (Reporter Li Meijuan) Anyi County traditional Chinese Medicine Hospital in Nanchang City has the problem of using dead people's social security cards to swipe cards in hospital to defraud medical insurance funds, involving a medical insurance fund of 7300 yuan; Ganzhou Dashenlin chain drugstore Co., Ltd. Nantang store fraud health insurance fund behavior, involving an amount of 5900 yuan. In the past year or so, the medical security department of Jiangxi Province has continuously maintained a high-pressure situation of cracking down on fraud and insurance fraud. Up to now, 7557 illegal medical institutions have been dealt with by means of on-the-spot inspection, cross-examination, and reward for reporting. To recover 168 million yuan from the medical insurance fund.
It is understood that in the past year or so, the medical security departments of Jiangxi Province have successively carried out a number of special actions to crack down on fraud and insurance fraud, focusing on the inspection of violations such as fictitious services in designated hospitals and exchange projects in designated pharmacies. At the same time, through the implementation of the reporting reward system, we will mobilize the masses to report violations of laws and regulations, and build a socialized supervision mechanism for medical security. The interim measures of Jiangxi Province for reporting and rewarding fraudulent Medical Security Fund acts have been formulated to clarify the behavior of fraudulent fraudulent medical security funds, ways of reporting, reward standards, etc., with a maximum reward of 100000 yuan for reporting.
Of the 7557 illegal institutions handled, 340 suspended health insurance services, 104 lifted health insurance services, 708 administrative fines and 5 transferred to judicial organs. The amount involved in dealing with the violations involved 269 million yuan, of which 168 million yuan was recovered from the Medical Insurance Fund and 48.44 million yuan in administrative fines; 103 violations were handled and 21 were handed over to the judiciary.
In addition, Jiangxi Province is grabbing the opportunity of "two pilot and one demonstration" reform of the national medical insurance fund supervision, and is actively promoting the pilot project of fund supervision mode innovation, the construction of fund supervision credit system and the construction of medical insurance intelligent monitoring demonstration site.