倒卖医保回流药
Search documents
涉生育津贴骗保、倒卖医保回流药,医保基金监管“百日行动”启动
第一财经· 2025-09-25 07:07
Core Viewpoint - The National Healthcare Security Administration (NHSA) has launched a "100-day action" to address prominent issues in medical insurance fund management, aiming to eradicate illegal practices such as the resale of medical insurance drugs by the end of 2025 [1] Group 1: Focus Areas of the Initiative - Comprehensive governance of the resale of medical insurance drugs will be conducted, targeting issues such as falsifying prescriptions, fraudulent use of medical insurance credentials, and illegal sales by healthcare professionals and insured individuals [2] - The initiative will closely monitor key links in the resale of medical insurance drugs, with findings related to counterfeit documents and fraudulent practices being reported to relevant authorities for coordinated action [2] Group 2: Special Investigations - A special investigation will be conducted on excessive prescription practices, focusing on abnormal prescription and purchase behaviors, including those that exceed clinically reasonable amounts and mismatched prescriptions [3] - The initiative will also target the chain of benefits transfer, investigating cases where individuals collude with fraudsters to exploit the medical insurance system [3] Group 3: Addressing Maternity Benefits Fraud - The NHSA will focus on fraudulent claims for maternity benefits, including the submission of false documentation and inflated payment bases [4] - There will be an emphasis on increasing punitive measures against confirmed illegal activities, with a commitment to recover misappropriated medical insurance funds and report findings to law enforcement [4]