The junior of the Central Commission for Discipline Inspection has now found a lot of problems

The Central Commission for Discipline Inspection once again focused on the details of this year's medical insurance flight inspection.

On August 29, the official website of the Central Commission for Discipline Inspection issued the article "Medical Insurance Flight Examination found that super medical insurance payment limited, over -inspection, repeated charging collective" pulse "finding problems", in detail the inspection of the medical insurance flight inspection team entered the second affiliated hospital of Kunming Medical University content.

The article mentioned that there are issues such as super -medical insurance payment, excessive inspection, repeated charges, and super -standard charges in the second hospital of Kunyi Medical University.

The medical insurance flight inspection team found that after more than 1,100 insured persons in the second hospital of Kunyi, after being discharged from the hospital, they were re -admitted to the hospital for the same disease the next day. "Dragon Ball Ointment", "Ginkgo Leaf", "Calcium Carbonate D3" and other drugs are limited to outpatient clinics. This hospital is used for hospitalization patients and settled medical insurance settlement.

In addition, after reading more than 300 cases, the inspection team found that the surgical amount of "same alien bone" did not match the number of bills, and there was a significant access, involving the suspected violation of 3740 yuan.

These publicly disclosed information shows that the medical insurance flight inspection team was very detailed.

The former dean was a typical negative example

All departments in the hospital do the same examination for patients admitted patients

The reason why the second hospital of the Kunyi Medical University will be "dissected the sparrow" by the State Medical Insurance Bureau and the Central Discipline Inspection Commission, which is likely to be investigated because of the former deputy secretary of the party committee and dean of the hospital.

In January of this year, the Propaganda Department of the Central Commission for Discipline Inspection launched a series of special films "Zero tolerance". As a typical case, the Malin Kun case was broadcast in the first episode.

Malin Kun was once a doctor with outstanding business capabilities. After entering the hospital leadership position, he gradually deviated from the original intention of treating the disease and saving people. Especially after serving as the president of the hospital in 2011, the behavior of monetizing with the power of power became intense.

The documentary at the time disclosed that Marin Kun and his wife's brother Yang Satellite agreed to procure the CCP for profit from medical equipment. In order to cover up people's eyes, Yang Sangang served as the spokesperson of Malin Kun, and found another person Wu Nan as the middleman to build the entire interest chain.

From 2012 to 2017, with the help of Malin Kun, Jiang Jianhua, a medical equipment dealer, was purchased by the second hospital of Kunyi at the second hospital of the Kunyi. The huge benefits fee was given by Wu Nan to Yang Southern and Malin Kun. Malin Kun, who tasted the sweetness, became more and more daring, began to skip the middlemen, and directly contacted more merchants. Finally, the total amount of bribery that was verified was more than 30 million yuan.

It is not surprising that the second hospital of Kunyi University has become the focus of this medical insurance flight inspection.

On the first day of entering the second affiliated hospital of Kunyi University, the inspection team proposed that no doubts were missing. At that time, all staff were allocated as: a comprehensive policy guarantee group, medical group, collection group, information group, financial group and other groups, focusing on different key points to conduct inspections.

The use of consumables in orthopedic surgery is the most difficult to regulate. The Jianzhi Bureau was informed that orthopedic consumables are generally used in the operating room, and patients cannot see the doctor's operation on the operating table. In particular, some commonly used inspection consumables, large use, long treatment cycle, and basically reimbursement of medical insurance.

In addition to the illegal phenomenon of orthopedic consumables "setting" such as orthopedic consumables, all departments of the hospital were also found to conduct a quantitative inspection of urine precipitation for patients admitted patients, involving 112,000 person -times, and the suspected illegal amount reached 2.246 million yuan. In addition to these, the second hospital of the Kunyi Medical University also has suspected illegal use of unprecedented drugs and offline procurement of illegal regulations; it is suspected that there are problems such as drug spelling and support.

The person in charge of the Second Hospital of Kunyi Medical University stated that he carefully checked and studied the rectification plan. The inspection of the second hospital of the Kunyi Medical University is nearing the end, and it will do a good job of investigating doubts and fixed evidence.

32 doctors were punished

Medical insurance flight inspection storm is coming

Just checking a second hospital in Kunyi, in fact, cannot solve the problem of "running and dripping" of the National Medical Insurance Fund.

The "2021 Medical Insurance Fund Flight Inspection Report" shows that during the inspection of the 68 -point institutions of the National Medical Insurance, 59 hospitals have repeated fees, super standard charges and decomposition projects. 30%.

This round of flight inspection is organized by the National Medical Insurance Bureau and directly targeted at local hospitals. It can be said that it is a "dimension reduction strike" from top to bottom. The main purpose is to combat fraudulent behavior, which is critical to purify the operating environment of the medical insurance fund. The role.

Yan Qinghui, deputy director of the National Medical Insurance Bureau, said: It is necessary to further play the deterrent effect and demonstration effect of flight inspection, and promote the improvement of the supervision and management of the medical insurance fund.

This year's medical insurance flight inspection has also been included in the supervision of the medical insurance departments of various provinces and municipalities. In May of this year, the State Medical Insurance Bureau issued a document for the first time requested the medical insurance departments in various places to conduct flight inspections; in July, the National Medical Insurance Bureau and the Ministry of Finance, the National Health and Health Commission, and the National Trade Culture Bureau of the State Administration of Traditional Chinese Medicine organized a national level of flight inspection.

The Department of Cardiology and Orthopedics are the focus of audit. From the description of the Flying Inspection of the Second Hospital of Kunyi Medical University, it can be seen that the division of flights organized by the national level is clear and cooperated with each other, and even a small problem cannot be avoided.

The Jianzhi Bureau was informed that the national unified medical insurance information platforms of 14 subsystems including drug and medical consumables management, payment method management, and medical service price management have been completely completed.Wang Wenjun, director of the Department of Planning and Regulations of the State Medical Insurance Bureau, believes that the platform facilitates data to recognize, circulate, share, and promote the interconnection and more transparent in inter -provincial price information.The medical insurance flight inspection increased the analysis of hospital data.The Jianzhi Bureau was informed that some provinces and cities have launched the "reasonable online review system", and intelligent review of a single prescription or inpatient doctor's order only takes 0.2 seconds. The unsuitable prescription or doctor's order is intercepted and reminded while the doctor's prescription.

According to the news disclosed by the official website of the Central Commission for Discipline Inspection on July 3, 32 doctors with bad practice have been scored.

Writing ｜ Xiaomi

Edit ｜ Jiang Yun Jia Ting

Operation | Valley

Illustration | Visual China

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