2026年医保基金飞行检查将实现全覆盖

Group 1 - The National Healthcare Security Administration (NHSA) will enhance flight inspections nationwide by 2026, covering all provinces and various stakeholders including medical institutions, insurance agencies, and insured individuals [1] - Annual flight inspections will focus on regions with high risks in healthcare fund operations, abnormally high hospitalization rates, and issues with fund usage, particularly in key areas such as orthopedics, oncology, and neurology [1] - Special flight inspections will target prominent issues raised by the public regarding illegal use of healthcare funds, and there will be an exploration of long-term care insurance inspections [1] Group 2 - NHSA will collaborate with relevant departments to combat fraud in healthcare insurance, aiming to reduce existing cases and prevent new ones [2] - The administration will continue actions against illegal activities related to drug traceability, including the sale of returned drugs and excessive prescriptions [2] - NHSA plans to enhance the development and application of big data regulatory models to monitor typical illegal behaviors and improve the overall regulatory framework [2] - A proactive warning system will be implemented to strengthen preemptive measures, with a target of achieving a 70% access rate for designated medical institutions by the end of 2026 [2]