2026年医保基金飞行检查将全覆盖

Core Viewpoint - The National Healthcare Security Administration (NHSA) will intensify flying inspections in 2026, aiming for nationwide coverage of all provinces and various healthcare entities, focusing on multiple insurance types including basic medical insurance, maternity insurance, major illness insurance, and long-term care insurance [1] Group 1: Flying Inspection Expansion - The NHSA will comprehensively promote the expansion and quality improvement of flying inspections, targeting regions with high risks in healthcare fund operations, abnormally high hospitalization rates, and ineffective rectification of inspection issues [1] - Annual inspections will focus on healthcare institutions with significant fund usage and areas with concentrated reports and data screening issues, particularly in key fields such as orthopedics, oncology, and neurology [1] Group 2: Special Inspections and Actions - Special flying inspections will address prominent issues of illegal and irregular use of healthcare funds that are of public concern [1] - The NHSA will explore conducting special flying inspections for long-term care insurance and implement targeted inspections based on data anomalies and complaints [1] Group 3: Regulatory Measures - The NHSA will collaborate with relevant departments to continue special rectification efforts against fraud in healthcare insurance, aiming to reduce existing issues and prevent new ones [1] - Ongoing actions will include the use of drug traceability codes to combat illegal activities in the healthcare sector and the enhancement of big data regulatory models [1]