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Guarding the people’s "seeing a doctor", "helping money" Gansu high -pressure cracking fraudulent behavior

People’s Daily Online, Lanzhou, April 26 (Wang Wenjia) "Medical Insurance Fund is the" seeing money "of the people ‘" life -saving money’. , Effectively curb the torrential frequency of fraudulent scamming for fixed pharmaceutical institutions.

In 2021, the province’s medical insurance system inspected a total of 10,567 designated pharmaceutical institutions, investigated and punished 4,958, and the total penalty reached 100 million yuan.

Feng Lianbao, deputy director of the Gansu Provincial Medical Insurance Bureau.

On April 26, the Gansu Provincial Government Information Office held a press conference on the supervision of the Gansu Provincial Medical Security Fund. Feng Lianbao introduced the development of the Gansu Provincial Medical Insurance Fund in 2021 and the work plan in 2022.

It is understood that in 2021, the Gansu Provincial Government incorporated the "Establishment and Promotion of Medical Insurance Fund Supervision and Long -term Mechanism" into the key tasks of the government work report. The disciplinary inspection and supervision organs were transferred to the medical security fund supervision to find the problem of problem clue work procedures ", and established a working mechanism for the problem clue of the medical security fund supervision to the medical security fund supervision of the disciplinary inspection and supervision department. Gansu Province has revised the "Implementation Measures for the Reading Report Reward of Funding the Medical Security Fund in Gansu Province", and the complaint report reward mechanism is more sound.

The Gansu Provincial Medical Insurance Department has established a provincial leadership group and joint work classes for provincial -level special rectification operations of fraudulent defrauding insurance insurance to combine the special rectification operation of the province.

The Gansu Provincial Medical Insurance Bureau continued to maintain a high -pressure situation of fraud, adherence to supervision and inspection, combining full coverage with shortcomings, focusing on the key points, and expanding fields, continuously strengthening daily supervision, resolutely cracking down on fraudulent behaviors, and effectively maintaining the safety of medical insurance funds. "We insist on conducting full coverage inspections, for the problem of ‘fake patients, false illness, fake bills’ three fake fraud and fraud, and prominent problems of urban and rural residents’ medical security funds, combined with flight inspections, special rectification, daily inspections,’ point lines’ unclear power To achieve the full coverage of the supervision and inspection of fixed -point pharmaceutical institutions. On the other hand, we also conducted multiple forms of inspections.

Adopt cross -examination, clue strict inspections, key inspections, third -party assistance inspections, data monitoring, etc., expand the scope of inspection, increase the frequency of inspection, and enhance the randomness, professionalism, and effectiveness of supervision and inspection.

Feng Lianbao said. This year, Gansu Province will improve the work mechanism of the medical insurance fund supervision and the effective connection of criminal justice, adjust the expansion of the provincial comprehensive supervision leadership group, improve the departmental linkage mechanism, strengthen the organization and leadership of the fund supervision work, and give full play to the advantages of the department’s functions. Formed a joint force and exert the effectiveness of overall supervision. According to reports, according to the unified deployment of the country, from now until the end of December, the Gansu Provincial Medical Insurance Bureau will work with the Provincial Public Security Department and the Provincial Health and Health Commission to focus on the designated medical institutions at the grassroots level, medical and nursing institutions, Fixed -point medical institutions, designated medical institutions, and key areas such as cash cash in violation of regulations for medical insurance cards have been punched, and special rectification operations for "fake patients, fake diseases, and fake bills" will continue to carry out "fake patients, fake illness, and fake bills."

In addition, the Gansu Provincial Medical Insurance Bureau will further enhance the accuracy of the fund supervision, formulate the rules and discipline benchmarks of the administrative penalty of the Gansu Provincial Medical Security Fund to use the administrative penalties of the administrative punishment of the administrative penalty of the administrative penalty of the administrative penalty of the administrative penalty, and guide the regulatory agents of various regulations. Supervision; early warning of fund supervision data monitoring indicators, use big data screening, and scientifically regulate fund supervision.

"We will continue to unblock the channels for reporting reports, collectively solicit clues of violations of laws and regulations, implement the reporting and reward system, increase the exposure of typical cases, actively invite social supervisors and news media to participate in supervision and inspection, and carry out the" Weaving Fund Supervision Network Together The centralized publicity activities of the theme of the medical insurance protection line ‘theme have promoted the formation of a good atmosphere of fund supervision of the fund’s joint concern, supporting, and participation. "Feng Lianbao said. (Responsible editor: Jiao Long, Wang Tong) Share let more people see recommended reading.