持续开展医保基金管理突出问题专项整治 今年飞行检查将实现全覆盖

Group 1 - The core viewpoint of the article emphasizes the National Medical Insurance Administration's commitment to strengthening the regulation of medical insurance funds in 2026, focusing on combating illegal use of these funds and maintaining a high-pressure regulatory environment to ensure fund safety [1][3] - A key priority for this year's medical insurance fund regulation is the ongoing special rectification of prominent issues in fund management, particularly targeting fraud and abuse in the medical insurance system, with a firm stance on "reducing existing issues and curbing new ones" [1] - The notification outlines plans for enhanced flying inspections, integrating national, provincial, and municipal checks to ensure comprehensive coverage across all provinces and various stakeholders, including medical institutions and insured individuals, focusing on high-risk areas and specific medical fields [1] Group 2 - The notification also specifies the continuation of special actions to combat illegal activities in the medical insurance sector, particularly those related to drug traceability codes, aiming to crack down on the illegal sale of returned drugs and other related violations [2] - The use of advanced technologies, such as artificial intelligence, is highlighted as a key focus for fund regulation this year, with an emphasis on developing and applying big data regulatory models to enhance oversight of typical illegal behaviors and medical practices [2] - The initiative aims to innovate and expand the practical applications of "artificial intelligence + medical insurance regulation," promoting the transformation of anti-fraud big data regulatory pilot results into actionable applications [2]