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反腐大片披露:医保监管人员遭围猎,医院将骗保当主业
Xin Lang Cai Jing· 2026-01-13 14:35
专题片介绍,"围猎"不仅是政治生态污染源,还直接侵害人民群众切身利益,在医疗保障、医药卫生领 域,这一点表现得非常典型。 中新网1月13日电 13日,反腐专题片《一步不停歇 半步不退让》第三集《清理"围猎"污染源》开播,辽 宁省锦州市医疗保障服务中心北镇分中心原主任李颖出镜忏悔,北镇市一起医保基金管理领域腐败案的 细节也随之披露。 尝到甜头的徐红梅,索性把医院的经营策略整体扭转,看病治病成了次要的,骗保成了真正的主营业 务。 医保分中心9名公职人员 "病人是找的,病例是编的,手术是假的" 医院竟将骗保当主营业务 专题片披露,2020年4月,李颖刚调到北镇医保分中心,心曙光医院负责人徐红梅就向他围拢过来。 心曙光医院是一家民营医院。经营过程中,徐红梅逐渐动了歪脑筋,觉得骗取医保资金是更快的生财之 道。从2014年开始,她设计了一整套骗保方案,给所有医护人员都布置了拉人头的任务,让他们四处招 揽患者。 专题片披露,心曙光医院大多打着免费体检、免费就餐、免交住院押金等看似公益的幌子,重点到农 村、养老院等地招揽患者。这些被他们瞄准的患者人群大多在不知情的情况下被利用。 病人是找的,病历是编的,手术是假的,整场骗局里 ...
民营医院为骗取医保设“围猎”专款 9名公职人员沦陷
Xin Lang Cai Jing· 2026-01-13 13:36
Group 1 - The article discusses the issue of corruption and malpractice in the medical insurance sector, particularly focusing on the "hunting" behavior that undermines the political ecology and harms public interests [1][3] - The Central Commission for Discipline Inspection and the National Supervisory Commission are intensifying efforts to address corruption related to medical insurance fund management, emphasizing accountability among public officials [3][25] - A case in Liaoning Province highlights the collusion between public officials and private medical institutions, leading to significant losses in medical insurance funds [5][29] Group 2 - The investigation revealed that the North Town Medical Insurance Service Center's former director, Li Ying, was a key target of "hunting" by private hospital representatives, leading to collective corruption among public officials [5][6] - The private hospital, Xin Shuzguang Hospital, employed various deceptive practices to defraud the medical insurance system, including creating fictitious medical records and unnecessary hospitalizations [12][16] - The fraudulent activities resulted in substantial financial losses for the medical insurance fund, with Li Ying reportedly receiving bribes totaling 685,000 yuan while causing significant losses to the fund [29][25] Group 3 - The article emphasizes the importance of maintaining the integrity of the medical insurance system to protect public health and ensure that funds are used appropriately [27][39] - Measures are being implemented to enhance oversight and accountability within the medical insurance sector, including regular monitoring of risk indicators and public reporting of issues [35][37] - The ongoing efforts aim to create a fair and transparent environment for medical services, ultimately benefiting the public and restoring trust in the healthcare system [39][41]
医保监管人员被金钱“拿下”,骗保竟成某民营医院主业
Xin Lang Cai Jing· 2026-01-13 13:35
Core Viewpoint - The documentary highlights the issue of corruption in the medical insurance sector, particularly focusing on how certain private medical institutions engage in fraudulent activities that harm public interests and undermine the integrity of the medical insurance system [1][21]. Group 1: Corruption in Medical Insurance - The documentary reveals that some private medical institutions have organized schemes to "hunt" officials in charge of medical insurance, leading to significant financial losses for the medical insurance fund and directly affecting public health rights [1][3]. - A specific case in Jinzhou, Liaoning Province, involves the North Town branch of the Medical Insurance Service Center, where nine public officials were investigated for colluding with a private hospital to defraud the medical insurance fund [3][5]. Group 2: Methods of Fraud - The fraudulent activities included creating "shadow accounts" with fixed percentages of medical insurance payouts (2% to 5%) designated for bribing public officials [5][18]. - The private hospital, Xin Shuzguang Hospital, employed various deceptive tactics, such as fabricating patient records and conducting unnecessary procedures to claim reimbursements from the medical insurance fund [11][13]. Group 3: Role of Officials - Key officials, including Li Ying, the former director of the North Town Medical Insurance Center, were targeted for bribery, with payments escalating from simple gifts to a fixed commission agreement of 1% to 2% of the funds received [7][20]. - The collusion between the hospital and public officials facilitated a system where fraudulent claims were processed without proper oversight, allowing the hospital to prioritize profit from insurance fraud over legitimate medical services [16][20].