海南省人民医院,被罚1506万余元
券商中国·2025-05-26 15:18

Core Viewpoint - Hainan Provincial People's Hospital has been fined 15,063,137.11 yuan for violating medical insurance fund regulations, including excessive examinations, duplicate charges, and including non-reimbursable expenses in the insurance claims [1][4]. Summary by Sections Violations and Penalties - The hospital was found to have committed multiple violations from June 1, 2020, to November 30, 2023, including excessive examinations, duplicate charges, and misclassification of expenses [2][3]. - The penalty was based on the Medical Insurance Fund Supervision and Administration Regulations, specifically Articles 15 and 38, which outline the responsibilities of designated medical institutions [2][3]. Regulatory Framework - Article 15 mandates that medical institutions must provide necessary medical services and issue accurate billing to insured individuals, prohibiting excessive or unnecessary medical services [2][3]. - Article 38 details specific prohibited actions, including excessive diagnosis, duplicate billing, and misclassification of expenses, with penalties for violations including fines and potential suspension of services [3][4]. Administrative Actions - The Hainan Provincial Medical Insurance Bureau issued the penalty based on the Administrative Penalty Law and relevant regulations, requiring the hospital to rectify its practices [4].