(Combating New Crown Pneumonia) China's National Medical Insurance Bureau: More than 11.5 billion yuan in funds recovered in 2019 to combat fraud and fraud
China News Service, Beijing, March 30th (Reporter Li Yanan) The "Medical Insurance Development Statistics 2019" released by China's National Medical Security Administration on the 30th shows that in 2019, special actions to combat fraud and fraud to obtain medical security funds will continue to be implemented. The department inspected 815,000 designated medical institutions on-site, investigated and dealt with 264,000 illegal and illegal medical institutions, and handled 33,100 insured persons in various places. The total amount of funds recovered was 11.556 billion yuan (RMB, the same below).
According to the statistical express report, as of the end of 2019, the number of people who participated in the full-scale basic medical insurance was 1,35.36 million, and the coverage coverage was stable at more than 95%. The total income and total expenditure of the basic medical insurance fund for the year were 23.33487 billion yuan and 1994.573 billion yuan, and the cumulative balance at the end of the year was 26.91211 billion yuan.
In terms of medical assistance and poverty alleviation through medical insurance, in 2019, 77.82 million people were subsidized to participate in basic medical insurance, and 61.8 million people were directly assisted. As of the end of 2019, the participation rate of the poor people who have set up files in rural areas has reached 99.9% or more. The comprehensive medical insurance and poverty alleviation policy benefited 200 million people from the poor, and helped 4.18 million people who were poor due to illness get out of poverty.
In terms of drug procurement, as of the end of 2019, the total statistics of 31 provinces (autonomous regions, municipalities) through the provincial-level centralized drug procurement platform online procurement orders totaled 991.3 billion yuan. The “4 + 7” concentrated drug procurement pilot areas in the 25 pilot regions completed an average of 183% of the agreed purchase volume, and the selected drug purchase volume accounted for 78% of the generic drug purchase volume.
In terms of direct settlement of cross-provincial medical treatment, as of the end of 2019, the number of direct settlement medical institutions for cross-provincial medical treatment was 27,608; the number of effective records on the national platform was 5.39 million. As of the end of 2019, all 41 cities in the Yangtze River Delta region have achieved full coverage of direct settlement of outpatient medical expenses across provinces. There are 5,173 designated medical institutions connected to the network, of which medical institutions with outpatient clinics in Shanghai have all been networked.
In terms of the supervision of medical insurance funds, the special action to combat fraud and deception of medical insurance funds continued. Medical insurance departments at all levels inspected 815,000 designated medical institutions on-site, investigated and dealt with 264,000 medical institutions that violated laws and regulations, of which 6,730 medical insurance agreements were cancelled, administrative 6,638 were punished and 357 were handed over to judicial organs. A total of 33,100 insured persons were handled in various places, 65,500 were suspended for settlement, and 1,183 handed over to judicial organs. A total of 11.556 billion yuan of funds were recovered throughout the year. (Finish)