The city notified 14 typical cases of fraudulent
insurance
News from this newspaper (Reporter Xie Li) Yesterday, the Municipal Medical Insurance Bureau reported 14 typical cases of insured individuals forging and altering bills to defraud insurance, seeking medical treatment under false names, and resale of drugs.
The Municipal Medical Insurance Bureau emphasized that the "Regulations on the Supervision and Administration of the Use of Medical Security Funds" was officially implemented on May 1 last year. The illegal and irregular behaviors involved in these 14 typical cases have seriously disrupted the medical security management order and endangered the vital interests of the general public. , severely punished in accordance with laws and regulations, and severe cases will be punished.
In order to continue to consolidate the effectiveness of the publicity of the Regulations on the Supervision and Administration of the Use of Medical Security Funds and strengthen the legal awareness of the insured, the Municipal Medical Insurance Bureau selected 14 typical cases in recent years.
Through sorting out, a reporter from Beijing Youth Daily noticed that in 14 typical cases, people with their own social security cards and the social security cards they found were used to sell medicines to defraud insurance, counterfeit bills to defraud insurance, borrow social security cards from their mothers, and use their children's social security cards. Cards to seek medical treatment under false names, and use of others' electronic medical insurance certificates to seek medical treatment under false names are all listed here.
It is reported that according to the "Regulations on the Supervision and Administration of the Use of Medical Security Funds", individuals have handed over their medical security certificates to others for false use; repeatedly enjoy medical security benefits; take advantage of the opportunity to enjoy medical security benefits to resell medicines, accept cash, in kind or obtain In the case of one of other illegal interests, the medical security administrative department shall order it to make corrections; if it causes the loss of the medical security fund, it shall be ordered to return it; if it belongs to the insured, the online settlement of its medical expenses shall be suspended for 3 to 12 months.
At the same time, an individual commits one of the acts prescribed in the preceding paragraph for the purpose of defrauding the medical security fund, causing losses to the medical security fund; or uses another person's medical security certificate to seek medical treatment or purchase medicine under false name; or through forgery, alteration, concealment, or alteration , Destroy medical documents, medical certificates, accounting vouchers, electronic information and other relevant materials, or fabricate medical service items, etc., and defraud medical security fund expenditures, in addition to handling in accordance with the provisions of the preceding paragraph, the medical security administrative department shall also defraud the amount. 2 More than 5 times the fine.
"Especially, the behavior of fraudulent insurance complies with the criminal law of fraud, and may be sentenced!" The relevant person in charge emphasized.
The Municipal Medical Insurance Bureau reminds every designated medical institution and every insured person that it is everyone's responsibility to maintain the safety of the medical insurance fund, and to report violations of laws and regulations to the medical insurance department in a timely manner, and the medical insurance department will reward them according to regulations after verification.