Core Viewpoint - The Supreme People's Court of China emphasizes the importance of safeguarding the medical insurance fund, which is crucial for public health and the sustainable development of the medical security system, and plans to strictly punish medical insurance fraud in 2024 [1][2]. Group 1: Legal Framework and Actions - The Supreme People's Court is drafting guiding opinions to clarify the legal handling of medical insurance fraud cases, including definitions of crimes, penalties, and procedural requirements [1]. - A special rectification campaign will be conducted in collaboration with the National Medical Insurance Administration to address illegal activities related to the medical insurance fund [1][2]. - In 2024, courts across the country concluded 1,156 cases of medical insurance fraud involving 2,299 individuals, with a year-on-year increase of 131.2%, recovering over 402 million yuan in losses [1]. Group 2: Case Studies - Case 1: The defendants, led by Ai, fraudulently inflated medical expenses and submitted false data to claim over 9.7 million yuan from the medical insurance fund, resulting in severe penalties for the main perpetrators [4][5]. - Case 2: Du, as the actual controller of a designated medical institution, manipulated medical records to admit patients who did not require hospitalization, defrauding the insurance fund of over 3.9 million yuan [6][7]. - Case 3: Dai engaged in the illegal sale of "recovered" medical insurance drugs without proper licenses, earning over 340,000 yuan, and was sentenced for concealing and disguising criminal proceeds [9][10]. - Case 4: Tao exploited the medical insurance system to fraudulently obtain drugs worth over 30,000 yuan, while Xu facilitated the illegal acquisition of these drugs, both receiving prison sentences for their actions [11][12].

人民财讯8月5日电，最高人民法院发布人民法院依法严惩医保骗保犯罪典型案例。各级人民法院依法从 严惩处医保骗保犯罪，重点打击幕后组织者、职业骗保人等。2024年，全国法院一审审结医保骗保犯罪 案件1156件2299人，一审结案数同比增长131.2%，挽回医保基金损失4.02亿余元。 ...

Core Viewpoint - The Supreme People's Court emphasizes the importance of safeguarding the medical insurance fund, which is crucial for public health and the sustainable development of the medical security system, and outlines measures to combat medical insurance fraud [1][2]. Summary by Sections Regulatory Measures - The Supreme People's Court has drafted guiding opinions on handling medical insurance fraud cases, clarifying the legal application, punishment, and procedural requirements [1]. - A special rectification campaign for illegal activities related to medical insurance funds will be conducted in collaboration with relevant departments [1]. - Courts will strictly punish medical insurance fraud, focusing on key perpetrators and professional fraudsters [1]. Case Statistics - In 2024, courts concluded 1,156 cases involving medical insurance fraud, with a total of 2,299 individuals involved, marking a 131.2% increase in case closures year-on-year, recovering over 402 million yuan in losses [1]. Judicial Recommendations - The Supreme People's Court has issued judicial recommendations based on research to strengthen the supervision of medical insurance funds and maintain their safety [1]. Public Awareness - The court has organized press conferences to publicize typical cases of medical insurance fraud, aiming to raise public awareness and create a positive social response [1]. Case Examples - **Case of Ai Mouzhong et al.**: Involves a private hospital that fraudulently inflated medical costs, resulting in a total fraudulent amount of over 9.7 million yuan [3][6]. - **Case of Du Moujun**: A hospital director who manipulated patient admissions and falsified medical records to defraud over 3.9 million yuan from the medical insurance fund [7][8]. - **Case of Dai Mouxiu**: Engaged in the illegal sale of "recovered" medical insurance drugs, resulting in a conviction for concealing and disguising criminal proceeds [9][10]. - **Case of Tao Mouyun and Xu Mouxia**: Involved in the fraudulent acquisition of medications through the misuse of medical insurance cards, leading to significant financial losses [11][13].

Core Viewpoint - The Supreme People's Court emphasizes the strict punishment of medical insurance fraud to protect the medical insurance fund and the legitimate rights of the public [1] Group 1: Legal Actions and Statistics - In 2024, courts nationwide concluded 1,156 cases of medical insurance fraud involving 2,299 individuals, with a year-on-year increase of 131.2%, recovering over 402 million yuan in losses [1] - The Supreme Court outlines penalties for individuals who misuse medical insurance benefits for illegal gains, including fines and suspension of medical expense settlements for 3 to 12 months [1] Group 2: Case Examples - A case involving defendant Tao Mouyun, who fraudulently obtained medical insurance funds by selling drugs without a medical history, resulted in losses exceeding 220,000 yuan [2] - Defendant Dai Mouxiu was sentenced to six years in prison for illegally purchasing and selling drugs obtained through medical insurance fraud, with total sales exceeding 340 million yuan [4][6] Group 3: Criminal Trends - The illegal acquisition and sale of drugs purchased through medical insurance fraud have become a severe issue, with organized crime groups profiting from these activities, leading to significant losses for the medical insurance fund and potential health risks for the public [3]