最高法发布人民法院依法严惩医保骗保犯罪典型案例

Core Viewpoint - The Supreme People's Court of China emphasizes the importance of safeguarding the medical insurance fund, which is crucial for public health and the sustainable development of the medical security system, and plans to strictly punish medical insurance fraud in 2024 [1][2]. Group 1: Legal Framework and Actions - The Supreme People's Court is drafting guiding opinions to clarify the legal handling of medical insurance fraud cases, including definitions of crimes, penalties, and procedural requirements [1]. - A special rectification campaign will be conducted in collaboration with the National Medical Insurance Administration to address illegal activities related to the medical insurance fund [1][2]. - In 2024, courts across the country concluded 1,156 cases of medical insurance fraud involving 2,299 individuals, with a year-on-year increase of 131.2%, recovering over 402 million yuan in losses [1]. Group 2: Case Studies - Case 1: The defendants, led by Ai, fraudulently inflated medical expenses and submitted false data to claim over 9.7 million yuan from the medical insurance fund, resulting in severe penalties for the main perpetrators [4][5]. - Case 2: Du, as the actual controller of a designated medical institution, manipulated medical records to admit patients who did not require hospitalization, defrauding the insurance fund of over 3.9 million yuan [6][7]. - Case 3: Dai engaged in the illegal sale of "recovered" medical insurance drugs without proper licenses, earning over 340,000 yuan, and was sentenced for concealing and disguising criminal proceeds [9][10]. - Case 4: Tao exploited the medical insurance system to fraudulently obtain drugs worth over 30,000 yuan, while Xu facilitated the illegal acquisition of these drugs, both receiving prison sentences for their actions [11][12].