Chinanews.com, May 10. According to the website of the National Medical Insurance Administration, the National Medical Insurance Administration's exposure platform exposed 10 typical cases in the third phase of 2021, including the case of Hainan Provincial Hospital of Traditional Chinese Medicine for illegal settlement of medical insurance funds, and Zhengzhou People's Hospital of Henan Province for illegal settlement of medical insurance. Fund case, the case of illegal settlement of medical insurance funds by the First People’s Hospital of Zunyi City, Guizhou Province, etc.
1. Case of illegal settlement of medical insurance funds by Hainan Provincial Hospital of Traditional Chinese Medicine
After further investigation by the Hainan Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was found that Hainan Provincial Hospital of Traditional Chinese Medicine has illegal settlement of medical insurance funds such as repeated charges, exchange of charges, multiple charges, high charges, and over-range medication, involving a medical insurance fund of 15,694850 yuan. .
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Hainan Provincial Hospital of Traditional Chinese Medicine for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the hospital’s illegal settlement of the medical insurance fund has recovered 10 million yuan, and the remaining part is being further recovered.
2. Case of illegal settlement of medical insurance fund by Zhengzhou People's Hospital of Henan Province
After further investigation by the Henan Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was discovered that Zhengzhou People’s Hospital had repeated charges, swap charges, bundled charges, overcharges, over-range treatment, over-range medication and other illegal settlement of medical insurance funds, involving medical insurance funds. 9381605.25 yuan.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Zhengzhou People's Hospital for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the medical insurance fund of 9381605.25 yuan that the hospital illegally settled has been recovered.
3. The case of illegal settlement of medical insurance funds by the First People's Hospital of Zunyi City, Guizhou Province
After further investigation by the Guizhou Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was discovered that the First People's Hospital of Zunyi City had repeated charges, multiple charges, package inspections, repeated medications, and other illegal settlement of medical insurance funds, involving 15577068.76 yuan of medical insurance funds.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of the Zunyi First People's Hospital for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the medical insurance fund of 15577068.76 yuan that the hospital illegally settled has been recovered.
4. Case of illegal settlement of medical insurance fund in Baoji High-tech Hospital of Shaanxi Province
After further investigation by the Shaanxi Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was found that Baoji High-tech Hospital had illegal settlement of medical insurance funds such as repeated charges, exchange of charges, and false charges, involving 4,906579.3 yuan of medical insurance funds.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Baoji High-tech Hospital for illegal settlement; 2. Request the hospital to rectify within a specified time.
At present, the medical insurance fund of 4,906579.3 yuan that the hospital illegally settled has been recovered.
5. Case of illegal settlement of medical insurance funds by the First People's Hospital of Baiyin City, Gansu Province
After further investigation by the Gansu Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was found that Baiyin City First People's Hospital had bed-hanging hospitalization, over-restricted medication, over-examination, diagnosis and treatment, overcharge and other illegal settlement of medical insurance funds, involving 3,13,336.34 yuan.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Baiyin First People's Hospital for illegal settlement; 2. Request the hospital to rectify within a specified time.
At present, the hospital’s illegal settlement of the medical insurance fund of 3,13,236.34 yuan has been fully recovered.
6. Case of illegal settlement of medical insurance funds by the Third People's Hospital of Xining City, Qinghai Province
After further investigation by the Qinghai Provincial Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was discovered that the Third People's Hospital had illegal settlement of medical insurance funds such as over-standard charges, repeated charges, over-charges, and over-range medications, involving 1,829,682.81 yuan.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Xining Third People's Hospital for illegal settlement; 2. Request the hospital to rectify within a specified time.
At present, the medical insurance fund that the hospital settled illegally has recovered 49,9004.4 yuan, and the remaining part is being further recovered.
7. Case of illegal settlement of medical insurance funds by Long'an County People's Hospital, Nanning City, Guangxi Zhuang Autonomous Region
After further investigation by the Medical Insurance Bureau of Guangxi Zhuang Autonomous Region based on the clues handed over by the National Flight Inspection Team, it was discovered that the Long'an County People’s Hospital in Nanning City had repeated charges, cross-swap charges, split charges, multiple charges, package inspections, over-range medication and other illegal settlement of medical insurance funds. , Involving the medical insurance fund 9831778.43 yuan.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Long'an County People's Hospital for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the medical insurance fund 9831778.43 yuan of illegal settlement of the hospital has been fully recovered.
8. Case of illegal settlement of medical insurance funds by Xiji County People's Hospital of Guyuan City, Ningxia Hui Autonomous Region
After further investigation by the Medical Insurance Bureau of Ningxia Hui Autonomous Region based on the clues handed over by the National Flight Inspection Team, it was found that Xiji County People’s Hospital in Guyuan City had illegal settlement of medical insurance funds such as cross-charging, disaggregated charges, over-recording of charges, and out-of-range treatment, involving medical insurance funds of RMB 453,9843.3. .
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of the Xiji County People's Hospital for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the medical insurance fund of 453,9843.3 yuan that was settled illegally by the hospital has been recovered.
9. The case of illegal settlement of medical insurance funds by Shihezi Traditional Chinese Medicine Hospital of the Eighth Division of Xinjiang Production and Construction Corps
After further investigation by the Medical Insurance Bureau of Xinjiang Production and Construction Corps based on the clues handed over by the National Flight Inspection Team, it was discovered that Shihezi Hospital of Traditional Chinese Medicine had violations of illegal settlement of medical insurance funds such as over-standard charges, repeated charges, cross-swap charges, bundled charges, and over-range medication, involving medical insurance funds of 3,140,542.52 yuan. .
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of the Shihezi Traditional Chinese Medicine Hospital for illegal settlement; 2. Request the hospital to rectify within a specified time.
At present, the hospital's illegal settlement of medical insurance funds of 3,140,542.52 yuan has all been recovered.
10. Case of illegal settlement of medical insurance fund in Linzhi Central District Hospital of Tibet Autonomous Region
After further investigation by the Tibet Autonomous Region Medical Insurance Bureau based on the clues handed over by the National Flight Inspection Team, it was discovered that Nyingchi Central Hospital had illegal settlement of medical insurance funds such as over-standard charges, repeated charges, and package inspections and tests, involving 1,178,968 yuan of medical insurance funds.
The local medical insurance department handled the following: 1. According to the agreement, recover the medical insurance fund of Nyingchi Central District Hospital for illegal settlement; 2. Request the hospital to rectify within a time limit.
At present, the medical insurance fund of 1,178,968 yuan that the hospital illegally settled has been recovered.