守好看病钱 铸牢安全网 2025年兰州市追回医保基金近亿元

Core Viewpoint - The Lanzhou Medical Insurance Bureau has successfully recovered nearly 100 million yuan in medical insurance funds in 2025 through a series of regulatory measures, ensuring the protection of public healthcare funds [1][2]. Group 1: Fund Recovery and Regulatory Measures - In 2025, Lanzhou's medical insurance system recovered 99.51 million yuan in funds and imposed administrative fines totaling 44.39 million yuan [1]. - The bureau focused on three main areas with 45 specific rectification tasks, collaborating with various departments to enhance regulatory effectiveness [1]. - A total of 3,840 designated medical institutions were inspected, resulting in actions against 2,910 institutions, including 2,586 consultations and 152 administrative penalties [2]. Group 2: Innovative Supervision and Data Utilization - The Lanzhou Medical Insurance Bureau implemented a "big data screening - medical record verification - expert review" model to address issues like excessive diagnosis and treatment, leading to the investigation of 16 medical institutions and the recovery of 800,150 yuan [1][2]. - The bureau established four work mechanisms to enhance regulatory efficiency and developed eight intelligent monitoring models to quickly screen and identify issues within vast amounts of medical insurance data [2]. Group 3: Source Governance and Public Awareness - The bureau encouraged designated medical institutions to conduct self-inspections, resulting in the voluntary return of 51.58 million yuan in improperly used funds [2]. - A public awareness campaign titled "Everyone is Responsible for Medical Fund Security" was launched to enhance the understanding of policies among medical insurance staff and designated institutions, fostering a community effort to safeguard fund security [3].