中新网8月5日电 据最高人民法院微信公众号消息，医保基金是人民群众的"看病钱""救命钱"，事 关广大群众的切身利益，事关医疗保障制度健康持续发展，事关国家长治久安。2024年，最高人民法院 充分发挥刑事审判职能作用，依法严惩医保骗保犯罪，切实维护医保基金安全和人民群众医疗保障合法 权益。 一是制定指导意见。牵头起草《最高人民法院、最高人民检察院、公安部关于办理医保骗保刑事案 件若干问题的指导意见》，明确医保骗保犯罪定罪处罚、法律适用、政策把握、办案要求及有关工作制 度机制等。 二是开展专项整治工作。会同国家医疗保障局等有关部门开展2024年医保基金违法违规问题专项整 治，同步部署全国法院开展2024年医保基金违法违规问题专项整治工作。 三是依法严惩医保骗保犯罪。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。 四是制发司法建议。在充分调研的基础上，系统梳理医保骗保犯罪高发、多发的原因，提出强化医 保基金监管的对策建议，制发《最高人民法院关于加强医保基金监 ...

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]