Core Viewpoint - The National Healthcare Security Administration (NHSA) will intensify flying inspections in 2026, aiming for nationwide coverage of all provinces and various healthcare entities, focusing on multiple insurance types including basic medical insurance, maternity insurance, major illness insurance, and long-term care insurance [1] Group 1: Flying Inspection Expansion - The NHSA will comprehensively promote the expansion and quality improvement of flying inspections, targeting regions with high risks in healthcare fund operations, abnormally high hospitalization rates, and ineffective rectification of inspection issues [1] - Annual inspections will focus on healthcare institutions with significant fund usage and areas with concentrated reports and data screening issues, particularly in key fields such as orthopedics, oncology, and neurology [1] Group 2: Special Inspections and Actions - Special flying inspections will address prominent issues of illegal and irregular use of healthcare funds that are of public concern [1] - The NHSA will explore conducting special flying inspections for long-term care insurance and implement targeted inspections based on data anomalies and complaints [1] Group 3: Regulatory Measures - The NHSA will collaborate with relevant departments to continue special rectification efforts against fraud in healthcare insurance, aiming to reduce existing issues and prevent new ones [1] - Ongoing actions will include the use of drug traceability codes to combat illegal activities in the healthcare sector and the enhancement of big data regulatory models [1]

Group 1 - The National Healthcare Security Administration (NHSA) will enhance flight inspections nationwide by 2026, covering all provinces and various stakeholders including medical institutions, insurance agencies, and insured individuals [1] - Annual flight inspections will focus on regions with high risks in healthcare fund operations, abnormally high hospitalization rates, and issues with fund usage, particularly in key areas such as orthopedics, oncology, and neurology [1] - Special flight inspections will target prominent issues raised by the public regarding illegal use of healthcare funds, and there will be an exploration of long-term care insurance inspections [1] Group 2 - NHSA will collaborate with relevant departments to combat fraud in healthcare insurance, aiming to reduce existing cases and prevent new ones [2] - The administration will continue actions against illegal activities related to drug traceability, including the sale of returned drugs and excessive prescriptions [2] - NHSA plans to enhance the development and application of big data regulatory models to monitor typical illegal behaviors and improve the overall regulatory framework [2] - A proactive warning system will be implemented to strengthen preemptive measures, with a target of achieving a 70% access rate for designated medical institutions by the end of 2026 [2]

Group 1 - The core viewpoint of the article is that the National Medical Insurance Administration will increase the intensity of flying inspections in 2026, aiming for nationwide coverage of all provinces and various stakeholders in the medical insurance system [1] Group 2 - The flying inspections will encompass designated medical institutions, handling agencies, insured individuals, and insured units, ensuring comprehensive oversight [1] - The inspections will cover multiple types of insurance, including basic medical insurance, maternity insurance, serious illness insurance, and long-term care insurance [1]

Core Insights - The provincial medical insurance flying inspections are being initiated across various regions, focusing on the issue of "return drugs" and fraudulent practices in medical insurance [1][2][3] Group 1: Inspection Overview - The provincial flying inspections will cover all medical service behaviors and costs from January 1, 2023, to December 31, 2024, with the possibility of extending checks to previous years or 2025 [1] - The inspections are organized in a collaborative manner involving provincial and municipal levels, with teams typically consisting of around 50 members, including experts from various fields [2] Group 2: Focus Areas - Key areas of inspection include medical institutions, retail pharmacies, insured individuals, and medical insurance handling agencies, with specific attention on self-inspection results in nine medical fields [3] - The "return drug" issue is highlighted, with a focus on tracking drug traceability codes to combat illegal resale practices [3][4] Group 3: Regulatory Actions - The inspections will lead to immediate reporting to drug regulatory authorities for any discovered illegal activities, including the sale of return drugs and counterfeit medications [4] - The National Medical Insurance Administration has previously recovered over 8 billion yuan through similar inspections, demonstrating the effectiveness of these regulatory measures [2]