Workflow
严查严打欺诈骗保 国家医保局启动医保基金管理专项整治
Di Yi Cai Jing·2025-09-25 06:49

Core Viewpoint - The National Medical Insurance Administration has launched a "100-day action" to address prominent issues in medical insurance fund management, aiming to eliminate illegal practices related to the resale of medical insurance return drugs by designated institutions by December 31, 2025 [1] Group 1: Focus Areas of the Action - Comprehensive governance of the resale of medical insurance return drugs, targeting issues such as falsifying prescriptions, fraudulent use of medical insurance vouchers, and illegal sales by professional prescribers and insured individuals [2] - Special investigation into excessive prescription practices, monitoring abnormal prescription and purchase behaviors, and identifying potential collusion in obtaining medical insurance drugs [3] Group 2: Specific Issues Addressed - Special governance of maternity allowance fraud, focusing on the verification of false documentation, fictitious employment relationships, and inflated payment bases to recover misappropriated medical insurance funds [4] - Emphasis on increasing punitive measures against identified illegal activities, with a commitment to publicize cases and educate the public on the consequences of such fraud [4]