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    Home > Active Ingredient News > Drugs Articles > Another batch of hospitals were investigated for medical insurance violations! Several public hospitals are also listed

    Another batch of hospitals were investigated for medical insurance violations! Several public hospitals are also listed

    • Last Update: 2019-12-20
    • Source: Internet
    • Author: User
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    [industry trends of pharmaceutical network] recently, according to the information of Taiyuan Medical Security Bureau, the city recently reported a number of cases of illegal collection of medical insurance fees by hospitals It is worth noting that 12 medical institutions were reported this time Among them, six public hospitals were notified, with the illegal amount ranging from 590000 to 8000 yuan, totaling over 1.19 million yuan In fact, as the "life-saving money" of the people, the medical insurance fund has always been deeply concerned by the state Shortly after the establishment of the National Medical Insurance Bureau, it launched a nationwide special action against fraud and insurance fraud At the beginning of this year, the notice on the supervision of medical insurance fund in 2019 (hereinafter referred to as the notice) was issued to carry out the special governance of fighting against fraud and insurance fraud in 2019, and the strict supervision and inspection of medical insurance expenses of medical institutions was officially launched In addition, the circular also pointed out that each province should, on the basis of the special action against fraud and insurance in 2018 and in combination with the local reality, determine 1-2 key points of special governance for weak links, and focus on cracking down severely In the special campaign, it can be clearly found that not only private hospitals and pharmacies, but also more and more public hospitals have been investigated For example, not long ago, in order to implement the document requirements of "Jiangxi Medical Security Bureau launched the special governance program of combating fraud and insurance fraud in 2019", Fuzhou Medical Security Bureau inspected a number of designated medical institutions by means of continuous strengthening publicity, strengthening department cooperation, and focusing on data analysis, and investigated and dealt with a number of typical cases of fraud and insurance fraud in accordance with the laws and regulations in the whole city Many public hospitals are listed On December 5, Liaocheng City's relevant departments held a press conference to introduce the investigation and treatment of cases in the field of medical insurance, which also mentioned public hospitals It is reported that by the end of November, there were 862 designated medical institutions, 1418 designated pharmacies and 1210 designated medical institutions in Liaocheng City The number of designated pharmacies was 1992, and the inspection coverage rate reached 140% A total of 18.981 million yuan of medical insurance fund was recovered, and 10.4469 million yuan of medical insurance fund was recovered by the municipal medical insurance bureau Among them, 18 public hospitals were recovered medical insurance fund of 4.199 million yuan In addition, not long ago, Hunan Medical Security Bureau issued a document, informing the recent typical cases of fighting against fraud and insurance violations In the six typical cases of serious fraud reported, a leading third-class hospital in the medical industry of Hunan Province is on the list Through investigation, the hospital has serious violations of medical insurance fund, such as falsely recording the cost of consumables such as surgical suture, over inspection and over medical treatment At present, all illegal medical insurance funds have been recovered and the total penalty is 33.5926 million yuan In general, the current situation of medical insurance fund income and expenditure has pushed the fight against insurance fraud to a new height Public medical institutions at or above the second level are becoming an important area for investigating and punishing breakdown charges, over standard charges, repeated charges, application project charges, unreasonable diagnosis and treatment and other illegal behaviors The increasingly strict supervision system and law enforcement means will promote the medical insurance supervision to change from the result of management to the process of management In the future, hospitals and doctors must be responsible for their own behaviors Only by improving services and standardizing behaviors can they get more medical insurance funding support and gain more benefits.
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