The Health Insurance Bureau informed: a number of hospital health insurance violations of the breach of contract

Author Xiao Qin recently, Sichuan Ba Zhong City Medical Security Bureau issued the "Ba Zhong City fixed-point medical institutions medical insurance violations typical cases" notice.
health insurance bureau in 2019 in the city's 42 designated medical institutions to check, found different situations of health insurance violations.
in this list of 42 reported violations, private and public hospitals are included, including the central hospital in Pakistan, the amount of violations as high as 3.3 million yuan, nearly 670,000 yuan in breach of contract.
hospital's official website shows that the central hospital in Pakistan and China is Sanjia Hospital, which has three hospital areas: Nanchi Hospital District, Nanba Hospital District and Infection Hospital.
hospital has 2358 beds, 2708 beds are actually open, and 2136 staff are in the hospital.
understood that the local health insurance bureau in accordance with the relevant regulations, in April this year made the return of illegal funds to the health insurance funds account and according to the default case of the penalty for breach of contract treatment. More than
sanjia hospital medical insurance violations according to the "look at the medical community" understand that, not long ago, Guangxi Zhuang Autonomous Region Medical Security Bureau party secretary, director Wang Zhongping wrote that in the health insurance bureau in 2020 to carry out self-examination self-correction inspection work, found that some of the three A hospital inspection results are not optimistic.
And according to the provincial and municipal official website news, in various places have been published to combat fraud to cheat medical insurance special inspection results, the last two years involved not only private hospitals, but also public hospitals, sanjia hospitals have frequently become the object of investigation.
December 2019, the Hunan Provincial Medical Security Bureau issued a Circular on the Recent Typical Cases of Combating Fraud, Fraud and Insurance Violations.
reported that the Three A Hospital, Xiangya II Hospital of Central South University, there is a false record of multiple surgical suitation and other supplies costs, over-examination, over-medical treatment and other serious violations of the use of medical insurance funds.
the government's illegal health insurance fund and fines totalling more than 30 million yuan.
In the same period, Taiyuan City Medical Security Bureau also reported a number of cases of hospitals illegally charging medical insurance fees, of which, Taiyuan city center hospitals have decomposition charges, did not strictly follow the consultation procedures to provide medical services charges, the declaration of non-city fixed-point institutions outside the inspection costs and other acts, involving nearly 100,000 yuan of medical insurance funds, was fined 5 times the breach of contract nearly 500,000.
2018, the Tianjin Human Resources and Social Security Bureau issued a public notice on administrative penalties for four designated medical institutions, including the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.
Publicity shows that the Tianjin Human Resources and Social Security Department, in accordance with the law, has forged and changed the medical records of insured personnel and repeated charges of the second affiliated hospital of Tianjin University of Traditional Chinese Medicine, which has been found to be in violation of medical insurance laws and regulations, and has been ordered to return medical insurance funds and fined more than 300,000 yuan.
same year, Tangshan City Health Insurance Bureau informed the "2018 public hospital special inspection action" situation, it is learned that the city's 24 public hospitals at this level of 20 health insurance violations, the violation rate of more than 80%.
, including the workers' hospital, Kaifeng General Hospital and other triple-A hospitals are also included.
Public hospitals also ushered in a health insurance inspection storm according to the "look at the medical profession" understand that as early as August 2019, Shandong Provincial Medical Security Bureau held a press briefing had revealed a new development, according to The Shandong Provincial Medical Security Bureau Deputy Director Guo Yishui said, in the investigation of the object, from primary medical institutions, private medical institutions to the public secondary and triple-A medical institutions.
the health insurance inspection extend to public level 2 or 3 hospitals? According to a private hospital director in Zhangzhou, Sichuan Province, the local health insurance bureau summarized a set of data show that private hospitals only accounted for more than 20% of the share of health care, public hospitals accounted for more than 70%, and more than 70%, the local several large hospitals accounted for nearly 50%, that is, private hospitals and primary health hospitals accounted for 40%, add up to less than a few large hospitals.
Xu Weicai, deputy director of the Health Bureau of Shanyang County, Shaanxi Province, admitted to the Medical Care Industry that at present, medical insurance information is being actively promoted, medical insurance management is changing from a hospital to a doctor, medical management will become more and more standardized, medical institutions, doctors must be proactive to adapt to change.
hospitals should change their ideas, raise awareness and establish a sense of the rule of law.
。