国家医保局通报！

Core Viewpoint - The National Medical Insurance Administration, in collaboration with relevant departments, has launched a nationwide special action to combat fraud and illegal activities in the pharmaceutical sector using drug traceability codes as a key tool [1]. Summary by Sections - Case Examples: Eight typical cases of fraud were announced, including a significant case involving a pharmacy in Lanzhou, Gansu Province, which was found to be reselling medical insurance drugs and illegally profiting from the medical insurance fund [2][3]. - Details of Fraudulent Activities: The Lanzhou pharmacy was discovered to have illegally collected medical insurance cards from local residents, processed fraudulent transactions, and resold high-value drugs, including cancer treatment medications. A total of 1,124 boxes of drugs across 135 varieties were seized during the inspection [2][3]. - Consequences for Offenders: The pharmacy's medical insurance service agreement was terminated, and the legal representative received a penalty of 12 points against their medical insurance payment qualifications. Other cases involved similar fraudulent activities across various provinces, including Wuhan, Changsha, and Xi'an, with issues such as falsified prescriptions and excessive drug dispensing [3][4]. - Regulatory Actions: The cases have been referred to law enforcement and health regulatory agencies for further action. The National Medical Insurance Administration emphasized the importance of drug traceability codes as unique identifiers for each drug, urging all medical insurance institutions to comply with procurement and settlement regulations [4].