Beijing, 5 May (Zhongxin Net) -- Hu Jinglin, director of the National Medical Security Administration, pointed out in Beijing on 18 May that the medical insurance fund is the "life-saving money" of the people, and the National Medical Insurance Administration has always regarded strengthening the supervision of medical insurance funds and maintaining the safety of funds as its primary task, severely cracking down on all kinds of illegal use of medical insurance funds, and never letting medical insurance funds become "Tang monk meat."
On the same day, the Information Office of the State Council held a series of themed press conferences on "the beginning of authoritative departments" to introduce the relevant situation of "implementing the major decisions and arrangements of the 5th National Congress of the Communist Party of China and focusing on promoting the high-quality development of medical insurance". Hu Jinglin said that after five years of efforts, the National Health Insurance Administration has promoted the formation of a high-pressure situation of medical insurance fund supervision through the combination of "points, lines and surfaces".
Specifically, Hu Jinglin said that the flight inspection achieved a "breakthrough on the spot" through "point-and-point" verification. The mechanism of "no prior notice, above investigation, and cross-inspection" has effectively solved the problem of "supervision of acquaintances at the same level", and cracked down on violations of laws and regulations when they are discovered, giving full play to the role of the "flying inspection" sword.
At the same time, designated medical institutions are encouraged to draw inferences from one case to another, self-examine and correct themselves, and avoid the recurrence of similar violations of laws and regulations. Medical institutions that take the initiative to self-examine and correct themselves are to give due consideration to the frequency of inspections, punishment discretion, and other aspects, fully embodying the law enforcement concept of combining leniency and strictness.
"Since 2019, the National Health Insurance Administration has sent a total of 184 flight inspection teams to inspect 384 designated medical institutions, and found suspected illegal use of relevant funds of 43.5 billion yuan." He said.
Hu Jinglin said that the special rectification achieved "online promotion" through "penetrating" inspection. The medical insurance department, in conjunction with public security, health and other relevant departments, focuses on key areas such as orthopedics, hemodialysis, and intracardia, as well as key behaviors such as key drug consumables, false medical treatment, and reselling medical insurance drugs, and targets supervision to remove "lesions" that erode people's "life-saving money". In 2022 alone, 2682,7261 cases were solved, 10,7 criminal suspects were arrested, and <>.<> billion yuan of medical insurance funds were recovered.
In addition, Hu Jinglin also introduced that daily supervision is empowered by data to achieve "a network on the surface". Make full use of modern information technologies such as intelligent monitoring and big data to accelerate the construction of an all-round, multi-level and three-dimensional regulatory system.
"In 2022, we collected $38.5 billion through intelligent monitoring of chargebacks and recoveries, accounting for approximately 26% of the total number of funds recovered. Only one big data model of fake hospitalization, accurate clues, arrested nearly 500 people, investigated and dealt with nearly <> million yuan. Hu Jinglin said. (End)