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According to the "Jiangxi Release" news, the Fuzhou Municipal Medical Security Bureau notified 6 typical cases of illegal use of medical insurance funds
.
1.
Cases of illegal charges and low-standard hospitalization in Nancheng Chengbei New District Hospital After investigation, from 2019 to 2020, Nancheng Chengbei Hospital has overcharged general diagnosis and treatment fees, used over-restricted medication, and low-standard hospitalization.
The medical insurance overall fund paid 66,400 yuan
.
According to the “Social Insurance Law of the People’s Republic of China”, the “Regulations on the Supervision and Administration of the Use of Medical Security Funds” and the “Service Agreement of Designated Medical Institutions”, the Nancheng County Medical Insurance Bureau charges more general diagnosis and treatment fees, uses over-restricted medications, and lowers A total of 66,400 yuan in standard hospitalization was recovered and ordered to rectify within a time limit
.
2.
Guangchang Fifth Hospital Falsified Expenses Case According to investigations, Guangchang Fifth Hospital has falsified records of traditional Chinese medicine penetration therapy, intravenous indwelling needle fees and other violations from 2020 to 2021, and the medical insurance coordinating fund paid 89,000 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", Guangchang County Medical Insurance Bureau made false records of Chinese medicine penetration therapy and intravenous indwelling in Guangchang Fifth Hospital.
A total of 89,000 yuan of needle costs were recovered and ordered to rectify within a time limit
.
3.
Lichuan County Xianghe Pharmacy Illegal Card Swiping Case According to investigations, in 2020, Lichuan County Xianghe Pharmacy violated the medical insurance card payment of Chinese medicine decoction pieces that were not paid for in the medical insurance catalog.
The medical insurance personal account paid 5700 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Lichuan County Medical Insurance Bureau provides medical insurance for the Chinese medicine decoction pieces that the store will not pay for the medical insurance catalog.
A total of RMB 5,700 for credit card payment was recovered and ordered to rectify within a time limit
.
4.
Yihuang Aimin Hospital's repeated charging case After investigation, in 2020 Yihuang Aimin Hospital used repeated methods to charge more diagnosis and treatment fees, hospitalization fees and other violations, and the medical insurance coordinating fund paid 2300 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Yihuang County Medical Insurance Bureau recovered a total of 2300 yuan of repeated charges and ordered rectification within a time limit
.
5.
Zixi Tingxian Traditional Chinese Medicine Hospital has been investigated for violations of fees.
In 2020, Zixi Tingxian Traditional Chinese Medicine Hospital has illegal use of traditional Chinese medicine injections, package inspections, and excessive prescribing of auxiliary drugs used by secondary medical institutions.
Medical insurance will be coordinated.
The fund paid 0.
91 million yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Zixi County Medical Insurance Bureau recovered a total of 9100 yuan of illegal charges and ordered rectification within a time limit
.
6.
The case of illegal charges in the health room of Tongjiang Village, Shandang Town, Le'an County has been investigated.
In 2020, the health room of Tongjiang Village, Shandang Town, Le'an County has unreasonable diagnosis and treatment, illegal use of restrictive drugs and other violations.
The medical insurance overall fund paid 13,700 Yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Le'an County Medical Insurance Bureau pursued a total of 13,700 yuan for unreasonable diagnosis and treatment and the use of restrictive drugs in violation of regulations.
Replied and ordered rectification within a time limit
.
.
1.
Cases of illegal charges and low-standard hospitalization in Nancheng Chengbei New District Hospital After investigation, from 2019 to 2020, Nancheng Chengbei Hospital has overcharged general diagnosis and treatment fees, used over-restricted medication, and low-standard hospitalization.
The medical insurance overall fund paid 66,400 yuan
.
According to the “Social Insurance Law of the People’s Republic of China”, the “Regulations on the Supervision and Administration of the Use of Medical Security Funds” and the “Service Agreement of Designated Medical Institutions”, the Nancheng County Medical Insurance Bureau charges more general diagnosis and treatment fees, uses over-restricted medications, and lowers A total of 66,400 yuan in standard hospitalization was recovered and ordered to rectify within a time limit
.
2.
Guangchang Fifth Hospital Falsified Expenses Case According to investigations, Guangchang Fifth Hospital has falsified records of traditional Chinese medicine penetration therapy, intravenous indwelling needle fees and other violations from 2020 to 2021, and the medical insurance coordinating fund paid 89,000 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", Guangchang County Medical Insurance Bureau made false records of Chinese medicine penetration therapy and intravenous indwelling in Guangchang Fifth Hospital.
A total of 89,000 yuan of needle costs were recovered and ordered to rectify within a time limit
.
3.
Lichuan County Xianghe Pharmacy Illegal Card Swiping Case According to investigations, in 2020, Lichuan County Xianghe Pharmacy violated the medical insurance card payment of Chinese medicine decoction pieces that were not paid for in the medical insurance catalog.
The medical insurance personal account paid 5700 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Lichuan County Medical Insurance Bureau provides medical insurance for the Chinese medicine decoction pieces that the store will not pay for the medical insurance catalog.
A total of RMB 5,700 for credit card payment was recovered and ordered to rectify within a time limit
.
4.
Yihuang Aimin Hospital's repeated charging case After investigation, in 2020 Yihuang Aimin Hospital used repeated methods to charge more diagnosis and treatment fees, hospitalization fees and other violations, and the medical insurance coordinating fund paid 2300 yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Yihuang County Medical Insurance Bureau recovered a total of 2300 yuan of repeated charges and ordered rectification within a time limit
.
5.
Zixi Tingxian Traditional Chinese Medicine Hospital has been investigated for violations of fees.
In 2020, Zixi Tingxian Traditional Chinese Medicine Hospital has illegal use of traditional Chinese medicine injections, package inspections, and excessive prescribing of auxiliary drugs used by secondary medical institutions.
Medical insurance will be coordinated.
The fund paid 0.
91 million yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Zixi County Medical Insurance Bureau recovered a total of 9100 yuan of illegal charges and ordered rectification within a time limit
.
6.
The case of illegal charges in the health room of Tongjiang Village, Shandang Town, Le'an County has been investigated.
In 2020, the health room of Tongjiang Village, Shandang Town, Le'an County has unreasonable diagnosis and treatment, illegal use of restrictive drugs and other violations.
The medical insurance overall fund paid 13,700 Yuan
.
In accordance with the "Social Insurance Law of the People's Republic of China", "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and "Service Agreements for Designated Medical Institutions", the Le'an County Medical Insurance Bureau pursued a total of 13,700 yuan for unreasonable diagnosis and treatment and the use of restrictive drugs in violation of regulations.
Replied and ordered rectification within a time limit
.