China National Medical Insurance Administration: The total recovery of medical insurance funds is about 50.6 billion yuan
China News Agency, Beijing, December 8th (Reporter Li Chun) Jiang Chengjia, Director of the Fund Supervision Department of the National Medical Security Administration of China, stated in Beijing on the 8th that from 2018 to October 2021, the National Medical Insurance Administration has recovered a total of about 50.6 billion medical insurance funds. Yuan (RMB, the same below).
The medical insurance fund is the people's "life-saving money" and "medical treatment money", and the security of the fund involves the vital interests of the general public.
In April this year, the National Medical Insurance Administration, the Ministry of Public Security, the National Health Commission and other departments jointly deployed a special rectification action to combat fraudulent insurance in accordance with the law.
On the 8th of this month, the National Medical Insurance Bureau held a media briefing to introduce the situation of strengthening the connection of executions and cracking down on fraudulent insurance.
Jiang Chengjia said that since the establishment of the National Medical Insurance Administration, it has always taken strengthening the supervision of medical insurance funds and maintaining fund safety as its primary tasks, coordinated and promoted the reform of the supervisory system, insisted on full coverage of daily supervision and inspection, no restricted areas, deepened complaints and reports and public exposure, and severely cracked down on them. Violations of laws and regulations in the medical insurance field have initially formed a high-pressure situation of medical insurance fund supervision.
From 2018 to October 2021, a total of about 2.34 million designated medical institutions were inspected, about 1 million cases were processed, and the total amount of medical insurance funds recovered was about 50.6 billion yuan.
Jiang Chengjia said that since the launch of this year’s special rectification action against fraudulent insurance, the National Medical Insurance Administration, in conjunction with the Ministry of Public Security, the National Health Commission and other departments, has made heavy strikes and precise strikes, closely cooperated, coordinated and linked actions, and focused on “fake patients, fake medical conditions, and fake medical conditions. We have established five mechanisms to achieve five enhancements and achieved initial results.
As of the end of October, the national medical insurance departments have investigated and dealt with 3970 cases involving "three fakes", 142 medical insurance service agreements have been suspended, 61 medical insurance service agreements have been cancelled, 196 insureds’ online settlement of medical expenses has been suspended, and 536 have been transferred to public security and judicial organs ( 76 disciplinary inspection and supervision agencies (persons) were transferred to them, and a total of 140 million yuan of medical insurance-related funds were recovered.
Zhu Zhixiong, director of the Criminal Investigation Bureau of the Ministry of Public Security of China, also said at the meeting that since the launch of the special rectification operation, as of the end of November, public security agencies across the country have eliminated 310 criminal gangs that defrauded medical insurance funds, arrested 4,124 criminal suspects, and uncovered medical insurance funds fraud. There were 1,695 cases, 370 million yuan of medical insurance funds were recovered, and initial results were achieved.
Jiang Chengjia pointed out that in this special rectification operation, medical insurance worked closely with the public security, health and health departments to continuously strengthen the connection of executions, leverage the joint advantages of the departments, and dig deep into the criminal activities of fraud and insurance, and investigated and dealt with a number of major cases of fraud and insurance, and punished them. A batch of illegal criminal suspects were exposed, a batch of typical cases of fraudulent insurance were exposed, and the high-pressure posture of cracking down on fraudulent insurance continued to be maintained, which demonstrated the strength and determination of the departmental joint efforts to resolutely crack down on illegal and criminal activities of medical insurance fraudulent insurance.
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