The Supreme People's Court recently released four typical cases of medical insurance fraud, involving multiple links such as designated medical institutions defrauding insurance, insured persons embezzling drugs, and drug traffickers illegally reselling drugs. These cases fully demonstrate the determination and strength of the judicial authorities to crack down on the crime of medical insurance fraud throughout the entire chain, and also send a clear signal to the whole society: any behavior that erodes the medical insurance fund will be severely punished by law. The medical insurance fund is the "life-saving money" of the people, which is related to the health protection of billions of people. Once eroded, it not only damages national funds, but also the life-saving hope of patients. In recent years, the crime of medical insurance fraud has shown a high incidence trend. According to statistics from the Supreme People's Court, in 2024, 1156 cases of medical insurance fraud involving 2299 people were concluded in the first instance by courts nationwide, a year-on-year increase of 131.2%, and a loss of 402 million yuan was recovered from the medical insurance fund. This set of data reflects both the increasing crackdown by judicial authorities and the rampant criminal activities involved. From the typical cases released this time, it can be seen that the crime of insurance fraud has formed a situation of multiple intertwined subjects. A private hospital in Datong, Shanxi Province, falsely reported more than 9.7 million yuan in clinical medication and beds over a period of two years; Tao Mouyun, a insured person in Nanjing, Jiangsu, used his medical insurance card to falsely open and sell a large number of drugs, involving a total amount of over 220000 yuan; Dai Moushou in Jiangxi specializes in the purchase and sale of fraudulent insurance drugs, with a total amount involved of nearly 4 million yuan. These cases indicate that the criminal subjects of medical insurance fraud include not only designated medical institutions and insured persons, but also downstream actors who resell medical insurance drugs. It is necessary to implement a full chain crackdown in order to effectively curb it. Law is a powerful weapon to combat the crime of medical insurance fraud. According to China's Criminal Law and relevant judicial interpretations, defrauding medical insurance funds with the purpose of illegal possession constitutes the crime of fraud; Those who illegally purchase and sell fraudulent drugs will be punished for concealing or concealing the crime. In a typical case, the actual controller of the hospital involved was sentenced to 13 years and 6 months in prison and fined 500000 yuan; Insured individuals who falsely sell drugs are sentenced to three years and two months in prison and fined 30000 yuan; The drug dealer who resold drugs was sentenced to six years in prison and fined 120000 yuan. These judgments fully demonstrate the firm stance of the judicial authorities in cracking down on the entire chain of medical insurance fraud crimes. Maintaining the security of the medical insurance fund is a long and arduous task. In the face of increasingly covert and chain like insurance fraud, it is necessary to maintain a high-pressure crackdown situation, continuously improve regulatory systems, use big data and other technological means to enhance monitoring capabilities, and build a full chain governance system of "pre warning, in-process monitoring, and post accountability". Only with the joint participation and formation of the whole society can we effectively safeguard the "life-saving money" of the people and make the medical insurance fund truly used on the cutting edge of treating diseases and saving lives. (New Society)
Edit:Wang Shu Ying Responsible editor:Li Jie
Source:legaldaily.com.cn
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