China News Service, Nanchang, November 16th (Reporter Wu Pengquan) The reporter learned from the press conference of the "14th Five-Year Plan for the Development of National Medical Security in Jiangxi Province" on the 16th that in the past three years, Jiangxi has dealt with 35,000 medical institutions in violation of laws and regulations. Home, recovered 1.615 billion yuan in medical insurance funds.
The medical security fund is the people's "medical money" and "life-saving money", but it has also become the "tang monk meat" in the eyes of some lawbreakers, and fraudulent insurance frauds occur from time to time.
At the press conference that day, Yu Zhaohui, director of the Fund Supervision Division of the Jiangxi Provincial Medical Security Bureau and a first-level investigator, said that since the establishment of the Jiangxi Provincial Medical Insurance Bureau in November 2018, it has insisted on combating fraudulent insurance and maintaining fund security as its top political priority. The mission and the start of the "hard battle", focusing on both the symptoms and the root causes, comprehensively implementing policies, severely cracking down on fraudulent insurance activities in accordance with the law, and fully safeguarding the safety of the province's medical insurance funds.
The reporter learned that Jiangxi’s “Implementation Plan for Deepening the Reform of the Medical Security Fund Regulatory System Reform in Jiangxi Province” previously described the province’s "1+6+3+5" roadmap for the reform of the medical security fund regulatory system by 2025. "And the "mission book", took the lead in the establishment of a provincial medical security monitoring center in the country, and 11 districts and cities have successively achieved full coverage of medical security monitoring centers.
The Jiangxi medical insurance department has also coordinated with the public security, health and health departments to coordinate the implementation of the "autumn tackling" campaign and provincial unmanned inspections for combating fraud and insurance, and comprehensively use agreements, administrative, and judicial methods to establish a punishment system for combating fraud and insurance.
Statistics show that since 2018, Jiangxi has handled a total of 35,000 medical institutions that violated laws and regulations (including 4,700 administrative penalties and 317 medical insurance service agreements), and 318 illegal and illegal insured persons (of which 56 were transferred to justice). Department), a total of 1.615 billion yuan of medical insurance funds were recovered (including 275 million yuan in administrative penalties).
According to Mei, Secretary of the Party Leadership Group and Director of the Jiangxi Provincial Medical Insurance Bureau, as of the end of 2020, the number of participants in Jiangxi basic medical insurance was 47,799,700, and the insurance coverage rate remained above 95%.
"During the '14th Five-Year Plan' period, the province will continue to deepen the reform of the medical insurance fund supervision system in five aspects, accelerate the legalization, specialization, standardization and normalization of fund supervision, and strive to build a full-field and full-process fund security defense. Control mechanism, and try our best to protect the people's medical care money and life-saving money." Yu Zhaohui said.
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