Drugstores empty swipe health insurance card, strict inspection came...

Empty swipe health insurance card, drugstore disqualification so-called "empty swipe health insurance card", that is, in the case of patients did not seek medical treatment to buy medicine, through free medicine gifts, rebates and other ways to induce or attract insured personnel to drugstores, clinics or hospitals empty swipe health insurance card, or retain the collection of insured person's health insurance card to brush their own, to withdraw the health insurance fund.
inspection found that Jinan Lijian University Pharmacy Co., Ltd. Xiangtai City Store, Jinan Peng Chengge Big Pharmacy Co., Ltd. City Yiming Shop, World University Pharmacy Xinyuan Xin Shop (three pharmacies) there is a retained health insurance card swipe card, for non-targeted medical institutions to provide credit card settlement services.
in accordance with the provisions of the Jinan City Basic Medical Insurance Fixed-point Retail Pharmacy Service Agreement, the total deduction of performance bond yuan 29479.34 yuan, the lifting of the basic medical insurance fixed-point retail pharmacy service agreement.
to encourage reporting, the maximum prize of 100,000 yuan it is learned that Jinan City Medical Security Bureau Director Li Wenxiu informed the Jinan City Medical Security Fund use supervision and management of the Interim Measures (hereinafter referred to as the Interim Measures).
The Interim Measures make detailed provisions on the scope, division of duties, inspection procedures, illegal handling and social supervision of the medical insurance fund, and implement the whole process of supervision over the management and use of the medical security fund, which not only clarifies the rights and obligations of designated pharmaceutical institutions, physicians, pharmacists and insured persons, but also standardizes the regulatory authority, procedures and penalty standards.
Interim Measures encourage the strengthening of social supervision and create a good atmosphere in which "everyone is a supervisor of the health insurance fund" through measures such as the smooth channels of reporting and the establishment of incentive mechanisms.
", if the whistleblower who reports fraud and provides relevant evidence and clues is verified to be true, shall be rewarded in accordance with the relevant provisions.
" Li Wenxiu said that the report reward adheres to the combination of spiritual reward and material reward, material reward in accordance with the report clues to find out a certain proportion of the amount of fraud insurance, the maximum reward of 100,000 yuan.
Regulated pharmacies to swipe cards, the future more stringent September 1, the State Health Insurance Administration has officially announced the "Interim Measures for the Administration of Basic Medical Insurance Drug Use" (hereinafter referred to as the "Measures"), the "Measures" clearly stated that health care drugs, preventive vaccines and contraceptives and other drugs that do not meet the provisions of basic medical insurance drugs may not be included in the "Drug Catalog", that is, the future health care products-based batch of non-therapeutic drugs will no longer be able to swipe the health insurance card.
can be said that health care products can no longer be credit reimbursement, to a certain extent, will directly affect the frequency of customer consumption to pharmacies, will also directly affect the sales of pharmacies.
, the regulation of drugstores' credit card reimbursement drugs will undoubtedly be more stringent, and retail pharmacies will be the focus of supervision. More than
started, strict control of the health insurance fund on September 7, the State Health Insurance Administration issued the "Medical Security Administrative Law Enforcement Guidance" (hereinafter referred to as "Guidance"), the document not only on the local health insurance departments of the administrative law enforcement authority and responsibility is clearly defined, but also the first time to cheat the law enforcement of health insurance to give a clear legal basis, the authority of medical insurance administrative law enforcement will be greatly enhanced.
In June this year, the State Health Insurance Administration issued the 2019 National Health Insurance Development Statistics Bulletin, showing that a total of 11.556 billion yuan was recovered in 2019;
can say that for the supervision of health insurance funds, the state is constantly increasing the size, and retail pharmacies, will also be the focus of supervision.
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