Jiangsu Taizhou High -tech Procuratorate: Procuratorial suggestion helps to improve the protection of medical insurance funds

On September 2nd, the People's Procuratorate of the Taizhou Pharmaceutical High -tech Zone in Jiangsu, in conjunction with the Taizhou Procuratorate, held the "Procuratorate Recommended Delivery and Medical Insurance Fund Protection Fair Chamber of Commerce" to give full play to the advantages of the concentrated jurisdiction of criminal cases of "big health" and delivered it to relevant departments to the relevant departments. The procuratorial proposal helps to build a safety defense line of the medical insurance fund.

Beginning in 2018, the Taizhou people Liu Mou and his ex -wife Xu Mou used dozens of medical insurance cards in himself and relatives and friends to reimburse the name of the corresponding medical insurance hospital for the reimbursement. In May 2022, the public security organs and the medical insurance department launched a special investigation of medical insurance deficit insurance and discovered the case. In July 2022, in accordance with the provisions of the concentrated jurisdiction of the "big health" case, the case was transferred to the procuratorate of the high -tech zone for review and arrest, and was organized by the prosecutor of the medical case team. The prosecutor was reviewed and determined that as of 2022, Liu and Xu had deceived a total of 250,000 yuan in the medical insurance fund. They approved the arrest of the two in accordance with the law for suspected fraud, and guided the investigating agency to check the upstream and downstream black industry chain to achieve a full -chain investigation. Fight, resolutely cut off the black hands of the medical insurance fund.

By handling this case, the medical case handling team realized that such cases reflected problems such as the need to improve the medical insurance supervision system and the need for reimbursement policies to be strengthened. To this end, the High -tech Zone Procuratorate carried out special procuratorial supervision activities for medical insurance funds based on the case as a cut. In order to protect the safety of the medical insurance fund, the procuratorial organs have issued procuratorial suggestions to relevant functional departments to promote the establishment of an information sharing mechanism, increase the publicity of medical insurance regulations, further standardize the medical insurance reimbursement process, and investigate the hidden dangers of the medical insurance fund from the root cause.

"The small case leads the" life -saving money "of the people. The procuratorial organs will further play the function of procuratorial supervision in the medical insurance field, use big data analysis to establish a legal supervision model, promote comprehensive performance of various functional departments, and form a full -chain protection of medical insurance funds. Chen Cheng, the person in charge of the medical handling team of the hospital, said.

(Bai Yixuan)

Review: Pan Ruikai

Intern editor: Gong Yuwei

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