Shanxi Notified Hospital of suspected illegal use of medical insurance funds: investigation has been opened
The reporter learned from the Shanxi Provincial Medical Insurance Bureau on the 14th that the Fenyang Municipal Medical Insurance Fund Special Investigation and Rectification Leading Group issued a report on the "Fenyang Cankang Traditional Chinese Medicine Hospital's suspected illegal use of medical insurance funds." Currently, the Fenyang Municipal Public Security Bureau has opened a case to investigate the case. , the relevant responsible persons were subject to criminal coercive measures.
In March 2024, Fenyang City launched a city-wide special rectification work on violations of laws and regulations in medical insurance funds. During the inspection, it was discovered that Fenyang Cankang Traditional Chinese Medicine Hospital was suspected of illegal use of medical insurance funds. To this end, the Fenyang Municipal Government established a special investigation and rectification leading group for medical insurance funds to conduct an in-depth investigation into such situations.
The report pointed out that the Fenyang Cankang Traditional Chinese Medicine Hospital involved is a small private comprehensive traditional Chinese medicine hospital with 20 approved beds in 2020 and an increase of 48 beds in March 2021. It offers diagnostic and treatment subjects such as preventive health department, medical laboratory department, medical imaging department, and traditional Chinese medicine department.
On April 30, the Fenyang Municipal Medical Insurance Bureau issued the "Emergency Notice on Carrying out Special Rectification of Violations and Violations of the City's Medical Insurance Fund", requiring two designated medical institutions in the city to compare the list of problems, carry out in-depth self-examination and self-correction, and further clarify the work priorities and Job requirements and organizational leadership division of labor.
On May 1, based on the preliminary verification, the Fenyang Municipal Medical Insurance Bureau issued a "Notice Ordering to Suspend the Payment of Medical Insurance Fees to Fenyang Cankang Traditional Chinese Medicine Hospital" to the Fenyang Municipal Medical Insurance Service Center; Fenyang Municipal Medical Insurance Service Center The "Notice on Suspending the Payment of Medical Insurance Fees to Fenyang Cankang Traditional Chinese Medicine Hospital" was issued to Fenyang Cankang Hospital.
On May 2, Fenyang Cankang Traditional Chinese Medicine Hospital reported a "Self-examination Report on the Use of Medical Insurance Funds" to the Fenyang Municipal Medical Insurance Bureau, and returned the illegally used medical insurance amount of 197,601 yuan to the Fenyang Medical Insurance Service Center account.
After investigation, Fenyang Cankang Traditional Chinese Medicine Hospital, in the name of regular physical examinations, transported special groups from local rural areas to the hospital for hospitalization, and provided free meals during their hospitalization. Staff from the Fenyang City Medical Insurance Task Force visited and investigated and collected evidence from the 26 people involved, and found that the investigation records of 8 people were inconsistent with the actual hospitalization status shown by the medical insurance system.
At present, the Fenyang Municipal Public Security Bureau has opened a case for investigation into the matter, and criminal coercive measures have been taken against those involved. In the next step, Fenyang City will draw inferences from one example, strike hard, conduct strict investigations, and build a strong defense line for the safety of medical insurance funds.
