4月1日起施行！事关你的医保

Core Viewpoint - The implementation details of the "Regulations on the Supervision and Management of Medical Insurance Fund Usage" will take effect on April 1, 2026, aiming to tighten the regulatory framework for medical insurance funds and protect public funds [1][3]. Summary by Category Regulations on Medical Institutions - The regulations clearly define fraudulent behaviors by designated medical institutions and their staff, including inducing others to seek medical treatment or purchase drugs under false pretenses [1][3]. - Five types of behaviors by designated medical institutions that will be legally punished include: 1. Organizing others to use medical insurance fraudulently to purchase drugs and medical supplies for illegal resale 2. Including non-medical expenses in medical insurance fund settlements 3. Including expenses from non-designated or suspended medical service institutions in settlements (except for emergency cases) 4. Re-settling already settled expenses 5. Fraudulently obtaining medical insurance fund expenditures through falsified documents [1][3]. Regulations on Individuals - The regulations specify six types of behaviors by individuals aimed at defrauding the medical insurance fund, including: 1. Using medical service documents or prescriptions issued to other insured individuals to seek medical treatment and enjoy insurance benefits 2. Concealing that medical expenses have been covered by workers' compensation or third parties when applying for reimbursements 3. Purchasing drugs, medical supplies, or services beyond reasonable needs during the enjoyment of insurance benefits and reselling them for cash or other illegal benefits 4. Long-term or multiple purchases and sales of basic medical insurance drugs to unspecified trading parties 5. Allowing others to use personal medical insurance credentials for cash or other illegal benefits 6. Other behaviors aimed at defrauding the medical insurance fund [2][4].