China News Service, Beijing, June 30 (Reporter Yu Lixiao) The Beijing Public Security Bureau and the Municipal Medical Insurance Bureau have jointly launched a special operation to combat fraud and defraud of medical security funds. Since the special operation was launched in 2019, a total of 47 cases involving medical insurance have been cracked. Since then, 12 criminal gangs have been killed, and 112 criminal suspects have been detained in criminal detention.
Beijing Shijingshan Police received various drugs from the scene. Photo courtesy of Beijing Police
Fictitious employment relationship to deceive social security
In February of this year, the Beijing Municipal Public Security Bureau's Environmental Food and Drug Brigade took the lead from the Municipal Medical Insurance Bureau that a technology company in Chaoyang had committed illegal acts of fraudulent insurance payment for the payment of social insurance for urban employees in a forged employment relationship. The Chaoyang branch set up a special team to carry out investigations, and on May 25, the network was closed, and the company's heads Li Moubin and Hou Mouzhu were captured; on May 26, the company's main department heads and financial managers were also captured. , 11 customer service supervisors and sales staff Wumou arrested.
After investigation, from March 2017 to October 2019, the technology company paid 3,100 social insurances for urban employees in the name of in-service employees by forging employment relations for employees who do not have labor relations, resulting in more than 2.73 million social insurance fund expenditures. At the same time, illegally applying for maternity allowance for 36 people including Liu Mou, resulting in more than 980,000 yuan spent by the state maternity insurance fund.
At present, 13 people including Li Moubin have been criminally detained by Chaoyang Public Security Branch in accordance with the law on suspicion of fraud.
Coincidentally, in August 2019, the Beijing Municipal Public Security Bureau's Environmental Food and Drug Brigade took over the clue from the Municipal Medical Insurance Bureau, and the Tongzhou District Social Security Center found that a human resources management company violated regulations to defraud maternity allowances and reimburse maternity medical expenses. Suspected.
The Beijing Municipal Public Security Bureau Environmental Food and Drug Brigade, Tongzhou Branch, together with the city and district medical insurance departments, set up a task force. After 4 months of in-depth investigation, on the basis of comprehensively fixing the relevant evidence, the police force was organized on January 7, 2020. Concentrating on the arrest operation, the specific person in charge of the company Gu Mouxia and many others were captured.
After investigation, since June 2017, the company has issued social insurance payment information on the Internet platform. Through fictitious labor relations between the insured personnel and the company, it has successively handled social insurance enrollment business for more than 2,800 people. The annual social security agency service fee is collected, of which more than 1,400 insured persons have illegally applied for maternity allowances, reimbursed maternity medical expenses and basic medical medical expenses, and the amount involved is 7.511 million yuan.
According to the police who handled the case, in this case, the suspects had a strong sense of anti-reconnaissance, frequently changed corporate legal persons, and frequently flowed insured personnel among 17 legal companies registered in the city to achieve the purpose of concealing illegal acts and evading supervision; And because the company and the insured have the same interest claims, making the illegal activities of both parties more concealed and not easy to be discovered.
At present, the specific person in charge of the company, Gu Mouxia, and six others have been approved for arrest by the Tongzhou Procuratorate on suspicion of fraud.
Rent social insurance card to resell medical insurance drugs
During the investigation of the Shijingshan Public Security Branch of Beijing Municipal Food and Drug Brigade, since March this year, there have been many "drug dealers" in front of some hospitals and community health service centers in their jurisdiction. Medical insurance drugs, and then resell to make a high profit margin.
On May 13th, the Shijingshan Public Security Branch Environmental Food and Drug Brigade Squadron, together with the Gucheng Police Station, the District Medical Insurance Bureau, the District Market Supervision Bureau, and other departments, carried out a centralized collection network to arrest the suspects Li Mouzhao and He Moubin in a rental house in the Bajiao area. On the spot, he received more than 1,000 boxes of various medical insurance drugs and 6 social security cards for renting others.
According to the suspects He Moubin and Li Mouzhao, the two took the initiative to talk to the medical staff near the hospital and community health service station to determine that they were insured persons, and after intending to "cooperate", they first paid 1300 to 1800 yuan For different amounts of medical insurance, the social security card will be rented at a monthly rent ranging from 300 to 400 yuan. Every time the insured person needs to go to the hospital to prescribe drugs, the suspect will inform him in advance of the drugs and the quantity he needs to take. After the insured person prescribes the drugs, the drug will be handed over to the suspect for reselling for profit.
At present, the suspects He Moubin and Li Mouzhao have been arrested by the Shijingshan Procuratorate for suspected fraud. The insured who provided the social security card to the suspect has been punished by the Medical Insurance Bureau for suspension of the social security card.
According to Gu Ran, head of the squadron of the Central Food and Drug Brigade of the Shijingshan Public Security Bureau, in mid-May this year, the police arrested a suspect who was reselling drugs at the entrance of a hospital. More than 2,000 boxes of various types of medical insurance drugs were obtained from the place of residence. The above-mentioned criminal suspects bought and sold medical insurance drugs around hospitals, community health service stations and other areas, usually at a price of 5 to 6 yuan per box. The unit price of up to 40 yuan is reselling, and the high difference profit is obtained for profit. At present, the above three suspects have been taken criminally by the Shijingshan Public Security Bureau according to law. (Finish)