Zhongxin Finance, April 20. According to the National Medical Insurance Bureau, during the period from January 2017 to September 2020, Wuhan Tongji Hospital had the problem of interchanging and falsely remembering high-value medical consumables for orthopaedics, defrauding medical insurance funds to pay more than 23 million yuan, Wuhan Tongji Hospital The Municipal Medical Insurance Bureau issued a fine of 59.246 million yuan for this decision.
In March 2022, according to the reported clues, the National Medical Insurance Bureau, together with the National Health Commission and the State Administration for Market Regulation, conducted an unannounced inspection of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (referred to as "Tongji Hospital") to guide Hubei Provincial Medical Insurance Bureau, Wuhan The Municipal Medical Insurance Bureau will verify and deal with the relevant issues.
The person in charge of the Fund Supervision Department of the National Medical Insurance Administration informed that, after investigation, it was found that from January 2017 to September 2020, Tongji Hospital had the problem of collusion and false records of high-value orthopedic medical consumables, and fraudulently obtained medical insurance funds to pay 23343609.64 yuan.
Wuhan Municipal Medical Insurance Bureau made the following actions in accordance with the "Social Insurance Law of the People's Republic of China" and "Regulations on the Supervision and Administration of the Use of Medical Insurance Funds": 1. Order rectification; 2. The hospital self-examined and voluntarily returned the amount of 19,157,462.10 yuan of defrauded medical insurance funds and fined twice 38314924.20 yuan; fined 5 times the fraudulent amount of 4186147.54 yuan found in the inspection, 20930737.70 yuan, totaling 59245661.90 yuan; 3. Order the hospital to suspend medical services involving the use of the medical security fund for 8 months; 4. Report to the public security and the market in accordance with laws and regulations Supervision, drug supervision, health, discipline inspection and supervision and other relevant departments transferred clues to the problem of the case.
At present, the loss of the medical insurance fund has been fully refunded, and the fines have been fully implemented.
The unannounced inspection also found that Tongji Hospital was suspected of illegally using 91.0741 million yuan of medical insurance funds in other medical behaviors in 2021, which is still being further verified and processed.
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