注意！巴中严查医保系统欺诈骗保行为_平昌论坛_游鸽网_四川巴中综合门户网站_了解巴中的第一选择

一杯清酒当人生 发表于 2020-6-10 11:41

注意！巴中严查医保系统欺诈骗保行为

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                     <span style="font-size: 14px;">6月9日，记者从市医疗保障局了解到，为进一步加强医疗保障基金监管，从即日起到今年10月底，我市将开展为期近半年的医保系统突出问题治理，严厉查处定点医药机构内外勾结欺诈骗保行为。</span>
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                                 <p style="line-height: 1.75em;">
                                    <span style="font-size: 14px;">整治重点</span>
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                           <section style="width: 20px;margin-right: -8px;">
                                 <img data-ratio="1.2972972972972974" src="https://mmbiz.qpic.cn/sz_mmbiz_png/yXJoD72icSRZTtPKI30CibSQy7z4bGxLvOazKnbwlrpXQOicOZP1JvlMpVMzOr01libGlushQOZuQiczjhaLFzX9Kdw/640?wx_fmt=png" data-type="png" data-w="37" data-width="100%" style="width: 100%;display: block;"/>
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                     <section style="display: flex;justify-content: flex-start;padding-top: 10px;padding-bottom: 10px;box-sizing: border-box;">
                        <section data-brushtype="text" style="width: 32px;height: 32px;border-radius: 50%;text-align: center;font-size: 18px;line-height: 32px;color: white;background: #7adad8;flex-shrink: 0;transform: rotate(0deg);">
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                                 <span style="font-size: 14px;">1</span>
                           </p>
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                           <section data-autoskip="1" style="font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;word-break: break-all;color: #4caeac;">
                                 <p style="line-height: 1.75em;">
                                    <span style="caret-color: #ff0000; font-family: 微软雅黑, Arial, sans-serif; font-size: 14px;">定点医疗机构：虚构医药服务、伪造医疗文书和票据的，为参保人员提供虚假发票的，将应由个人负担的医疗费用记入医疗保障基金支付范围的，为不属于医保范围的人员办理医保待遇的，为非定点医药机构提供刷卡记账服务的，挂名住院的，串换药品、耗材、物品、诊疗项目等欺诈骗取医保基金的。</span>
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                        <section data-brushtype="text" style="width: 32px;height: 32px;border-radius: 50%;text-align: center;font-size: 18px;line-height: 32px;color: white;background: #7adad8;flex-shrink: 0;transform: rotate(0deg);">
                           <p style="line-height: 1.75em;">
                                 <span style="font-size: 14px;">2</span>
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                        </section>
                        <section style="margin-left: 10px;">
                           <section data-autoskip="1" style="font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;word-break: break-all;color: #4caeac;">
                                 <p style="max-inline-size: 100%;min-height: 1em;cursor: text;line-height: 1.75em;box-sizing: border-box !important;outline: none 0px !important;">
                                    <span style="max-inline-size: 100%; cursor: text; font-size: 14px; box-sizing: border-box !important; outline: none 0px !important;">定点零售药店：盗刷医疗保障身份凭证、为参保人员套取现金或购买营养保健品化妆品生活用品等非医疗物品，为参保人员串换药品、耗材、物品，为非定点医药机构提供刷卡记账服务的，为参保人员虚开发票、提供虚假发票等欺诈骗取医保基金的。</span>
                                 </p>
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                     <section data-brushtype="text" style="display: flex;justify-content: flex-start;padding-top: 10px;padding-bottom: 10px;box-sizing: border-box;">
                        <section style="width: 32px;height: 32px;border-radius: 50%;text-align: center;font-size: 18px;line-height: 32px;color: white;background: #7adad8;flex-shrink: 0;transform: rotate(0deg);">
                           <p style="line-height: 1.75em;">
                                 <span style="font-size: 14px;">3</span>
                           </p>
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                        <section style="margin-left: 10px;">
                           <section data-autoskip="1" style="font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;word-break: break-all;color: #4caeac;">
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                                    <span style="caret-color: #ff0000; font-family: 微软雅黑, Arial, sans-serif; font-size: 14px;">参保人员：伪造医疗服务票据，将本人的医疗保障凭证转借他人就医或持他人医疗保障凭证冒名就医的，非法使用医疗保障身份凭证，套取药品、耗材等，倒买倒卖非法牟利等欺诈骗取医保基金的。</span>
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               <section style="padding: 1em;box-sizing: border-box;">
                     <section style="display: flex;justify-content: flex-start;padding-top: 10px;padding-bottom: 10px;box-sizing: border-box;">
                        <section data-brushtype="text" style="width: 32px;height: 32px;border-radius: 50%;text-align: center;font-size: 18px;line-height: 32px;color: white;background: #7adad8;flex-shrink: 0;transform: rotate(0deg);">
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                                 <span style="font-size: 14px;">4</span>
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                                    <span style="caret-color: #ff0000; font-family: 微软雅黑, Arial, sans-serif; font-size: 14px;">医疗保障经办机构：为不属于医疗保障范围的人员办理医保待遇手续的，违反规定支付医疗保障费用等。</span>
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                        <span style="font-size: 14px;">“医保基金是老百姓的‘救命钱’，具有‘专款专用’性质，将医保基金视作‘唐僧肉’而发生的欺诈骗保行为，最终损害的将是每一个参保人的切身利益……”市医保局相关负责人介绍，全市医疗保障经办机构，包括承办医保经办业务的商业保险机构，以及定点医药机构和参保人员，都是此次治理范围。治理内容包括医药机构内部与社会犯罪团伙（个人）勾结，与经办机构、与参保人员（患者）勾结等骗保行为。</span>
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                        <span style="font-size: 14px;">据介绍，整个治理工作以全覆盖监督检查与重点抽查相结合、自查自纠与抽查复查相结合、强化外部监管与加强内控管理结合，市区县联动，分级负责。抽查复查工作采取实地走访、听取汇报、调阅相关文件、查验流程环节、核对财务账目、重点线索追踪等形式，充分利用智能监审系统和大数据筛查分析，对发现的违规情况进行追踪核查。</span>
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                        <span style="font-size: 14px;">“对自查已退回基金的不再处罚，抽查复查发现自查自纠不到位、仍然存在违法违规行为，将依法从严顶格处理；构成违纪的移送同级纪委监委处理，构成犯罪的移送司法机关，并公开曝光。”市医保局医疗监管科科长戴燕表示。</span>
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                        <span style="max-width: 100%; color: #BFBFBF; font-size: 14px; box-sizing: border-box !important; overflow-wrap: break-word !important;">来源 / 巴中晚报</span>
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lovedwufei 发表于 2020-6-10 12:11

现在查又鸡儿用，很多都已经利用这个发财了！

空间发表于 2020-6-11 10:37

支持！

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注意！巴中严查医保系统欺诈骗保行为