针对医保基金管理突出问题打出“组合拳” 专项整治让群众更有“医靠”

Group 1 - The National Healthcare Security Administration (NHSA) has initiated a "100-day action" to address prominent issues in medical insurance fund management, focusing on illegal practices such as the resale of medical insurance drugs and fraudulent prescriptions [1] - The NHSA has launched a special investigation into excessive prescription practices, monitoring abnormal prescription behaviors and mismatches between prescriptions and diagnoses [1] - The NHSA is also targeting fraudulent claims related to maternity benefits [1] Group 2 - The NHSA has released a trial version of the "National Long-term Care Insurance Service Project Directory," which standardizes service items and payment scope for long-term care insurance [3] - The directory categorizes services into two main types: daily living care and medical care, with specific activities outlined under each category [3] - Regions starting new long-term care insurance programs must adhere strictly to the directory and cannot arbitrarily change the service scope [5] Group 3 - The NHSA is exploring the inclusion of intelligent services and supportive assistive devices related to long-term care in the payment scope [6] - Currently, nearly 190 million people are enrolled in China's long-term care insurance, with over 100 billion yuan accumulated in funds and expenditures exceeding 85 billion yuan [8] - During the 14th Five-Year Plan period, the program has benefited over 2 million individuals with disabilities [8]