Big move! What happened to the health care bureau's one-time treatment of 18 medical agencies?

The State Medical Security Administration has just worked with the Ministry of Justice on the latest version of the "Regulations on the Supervision and Administration of the Use of Health Care Funds (Draft for Comments)" to experts, industry associations and other opinions, on the use of health insurance funds supervision and control legislation is in full swing, there have been local health care bureaus began to hit hardOn May 29, the Health Insurance Bureau of Huainan City, Anhui Province, dealt with the violation of the law by 18 medical institutions and issued the first batch of "medical insurance doctors' tickets" to several doctorsAccording to Huainan City Health Insurance Bureau, the violations include local cancer hospitals, Chinese hospitals, community health service centers, pharmacies and other institutions, involving the amount of violations of nearly 8 million yuan, of which Chaoyang Hospital and Xinhua Hospital, the highest amount of violations, reached 1.9926 million yuan, 1.9126 million yuan, some hospitals were suspended for 1-6 months of medical insurance settlement services and other measuresIn addition, due to excessive examination, medical charges and medical records do not match the medical behavior, Huainan City Medical Insurance Bureau also issued three fixed-point hospital medical insurance physicians issued a "penalty order", the violation of the medical insurance physician to make a deduction process, and written notice to themselves and their fixed-point hospital, this is the Huainan City Health Insurance Bureau after the establishment of the first batch of "medical insurance doctor tickets." According to Huainan City Medical Insurance Bureau, this year its staff in a private hospital report verification process, access to two hospital records involving the contents of the report, found that there is an unreasonable phenomenon of laboratory testing, inspection, is an excessive inspection violation; It was found that 40 beds of inpatients were over-examined at a hospital in Shou County on the same dayAccording to the provisions of the local medical insurance physician system, Huainan City Medical Insurance Bureau decided to deduct the doctor Wang, Li a certain, Cao a certain three agreed medical insurance physician annual assessment score of 2 points, to recover the relevant violation of the medical insurance fund and give corresponding punishmentThis was described by the local media as "the future of the normal management of the medical insurance physician system began." It is reported that Anhui Province this year in the health insurance fund supervision issued a number of documents, clear the relevant measures and measures, the treatment of medical insurance physicians and medical institutions, is the content of these documentsBehind this is that since the establishment of the National Health Insurance Administration in 2018, launched a special action to combat fraudulent fraud and fraud of the health care fund, the first time in 2018 to set up a state-level reporting telephone, all over the special action, forming a high-pressure situationPart of the agency that the Huainan Health Insurance Bureau deals with this time is derived from reporting verificationRecently, the Anhui Provincial Medical Insurance Bureau issued the "Anhui Province Medical Security Supervision and Investigation Fund Recovery Process Management Interim Measures", covering the basic medical insurance funds of employees and residents, but also to expand the insurance, medical assistance, long-term care and other insurance funds, subdivided the conduct of the medical insurance supervision and investigationAnhui Province's regulatory action on health insurance funds has also achieved good resultsIn 2019, Anhui Province conducted on-site inspections of 34,000 fixed-point medical institutions through flight inspection and cross-checking, totalling 872 million yuan in recovery funds, and the increase in the province's medical insurance fund expenditure decreased by 6.9 percentage points year-on-year, indicating the huge amount of illegal use of health insurance fundsAt the national level, on April 11 last year, the State Health Insurance Administration issued the Regulations on the Use of Health Care Funds (Draft for Comments) to solicit public commentsAt present, the new version of the draft is still ongoing to scholars, industry associations and related industry organizations to seek advice, for refinementThe health insurance sector is more and more strong supervision of funds, in addition to Anhui, Shandong, Shanghai and other places out of the health insurance fund supervision-related documentsOn June 1, Shanghai will officially implement the Measures for the Supervision and Administration of Basic Medical Insurance in Shanghai, and may impose a maximum fine of 300,000 yuan on the basis of the return of the relevant basic medical insurance expenses to the designated medical institutions and retail pharmacies that violate the law, and suspend the service agreement or terminate the service agreementIn the national version of the document, there are currently experts and scholars to take more stringent measures.