以虚增用药、空挂床手段虚报医保金近千万，民营医院多人获刑

Core Points - The case highlights the fraudulent activities of a private hospital in China, where multiple individuals inflated drug prices, duplicated drug entries, and fabricated hospitalization costs to defraud the medical insurance fund by over 9.7 million yuan [1][2][3] - The Supreme Court emphasized the importance of punishing such fraudulent behaviors to protect the integrity of the medical insurance system while acknowledging the role of private hospitals in providing healthcare services [3] Summary by Sections Fraudulent Activities - The private hospital engaged in various fraudulent practices, including inflating drug prices, duplicating drug entries, and falsely reporting hospitalization costs, leading to significant financial losses for the medical insurance fund [1][2] - The total amount fraudulently reported by the hospital reached over 9.7 million yuan, with more than 2 million yuan remaining unpaid, indicating attempted fraud [1] Legal Proceedings - The case went through multiple levels of the judicial system, with the intermediate court and the high court both affirming the convictions of the defendants for their roles in the fraud [2] - Sentences varied based on the defendants' involvement, with the main perpetrator receiving a sentence of 13 years and 6 months, while others received sentences ranging from 4 to 11 years [2] Implications for the Industry - The Supreme Court's ruling serves as a warning to private hospitals and their staff about the severe consequences of engaging in fraudulent activities against the medical insurance system [3] - The court's approach reflects a balance between strict punishment for major offenders and leniency for those with mitigating circumstances, aiming to deter future fraud while maintaining social justice [3]