以法之力维护医保基金安全（法治头条）

Core Viewpoint - The article highlights the increasing challenges in the regulation of medical insurance funds in China, particularly focusing on the rise of fraudulent activities that threaten the integrity of these funds. The judicial system is actively addressing these issues through stringent legal actions against offenders [5][6][7]. Group 1: Medical Insurance Fraud Cases - In 2024, a total of 1,156 medical insurance fraud cases were concluded in first-instance trials, resulting in 2,299 individuals being sentenced, with a year-on-year increase of 131.2% in case closures, recovering over 402 million yuan in losses [5]. - A specific case involved a hospital in Shanxi where fraudulent activities led to the inflation of medical expenses by over 9.7 million yuan, with 7 million yuan successfully defrauded from the insurance fund [6][7]. - Another case highlighted involved a medical institution where the operator was sentenced to 12 years in prison for defrauding over 3.9 million yuan through false medical records and inflated treatment costs [7]. Group 2: Black Market for Recycled Drugs - The article discusses the illegal trade of drugs purchased through fraudulent medical insurance claims, with individuals forming criminal networks to profit from this activity. One individual was sentenced to six years in prison for selling over 390,000 yuan worth of such drugs [8][9]. - The illegal sale of these drugs not only results in financial losses for the medical insurance fund but also poses health risks due to improper storage and potential contamination of the drugs [9]. Group 3: Responsibilities of Insured Individuals - Insured individuals are warned against illegally selling drugs obtained through medical insurance claims, with one case resulting in a sentence of over three years for the offender who sold drugs worth over 220,000 yuan [10][11]. - The article emphasizes that individuals engaging in such fraudulent activities face severe legal consequences, including fines and imprisonment, as the judicial system intensifies its crackdown on medical insurance fraud [11][12]. Group 4: Characteristics of Medical Insurance Fraud - The article outlines four main characteristics of medical insurance fraud: concentration of crime types (mainly fraud), diverse criminal actors (including insured individuals), varied methods of fraud, and significant financial impact on the insurance fund [12]. - The judicial system is committed to strict enforcement against these crimes, aiming to recover losses and protect the integrity of the medical insurance system [13].