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涉146亿美元 美司法部称制止“史上最大规模”医保欺诈案
news flash· 2025-06-30 18:51
当地时间6月30日,美国司法部表示,已制止一系列试图从联邦政府骗取146亿美元的医疗保健欺诈案。 司法部称,该案是美国历史上规模最大的医疗保健欺诈行动。司法部对324名被告提起了刑事指控,并 扣押超过2.45亿美元的现金、豪华汽车和其他资产。官员表示,美国政府实际损失约29亿美元。(央视 新闻) ...
存在过度诊疗等违规行为!北京7家医保定点医疗机构被处理
Yang Shi Xin Wen· 2025-05-22 16:33
Core Viewpoint - The Beijing Medical Insurance Bureau reported the results of a special inspection aimed at combating fraud in medical insurance, revealing that seven medical institutions engaged in various illegal activities, resulting in losses to the medical insurance fund ranging from tens of thousands to hundreds of thousands of yuan. All misappropriated funds have been recovered [1] Group 1: Specific Violations by Medical Institutions - Beijing Jingda Hospital assisted others in impersonating patients to defraud the medical insurance fund, resulting in a loss of 167,200 yuan. The hospital was ordered to return the funds and pay a fine of 334,500 yuan, along with a six-month suspension of its agreement [2] - Beijing Changping Huiren Hospital fabricated medical service items to defraud the medical insurance fund, leading to a loss of 92,291.44 yuan. The hospital was ordered to return the funds and pay a fine of 369,100 yuan, with a six-month suspension of its agreement [3] - Beijing Jingbei Hospital engaged in excessive diagnosis and treatment, duplicate charging, and included non-reimbursable medical expenses in the medical insurance fund, causing a loss of 1,015,700 yuan. The hospital was ordered to return the funds and pay a fine of 1,015,700 yuan [4] - Beijing Cerebrovascular Disease Hospital also committed excessive diagnosis and treatment, duplicate charging, and included non-reimbursable medical expenses, resulting in a loss of 664,600 yuan. The hospital was ordered to return the funds and pay a fine of 664,600 yuan [5] - Beijing Si Hui Traditional Chinese Medicine Hospital was found to have similar violations, causing a loss of 425,400 yuan, and was ordered to return the funds and pay a fine of 425,400 yuan [6] - Beijing Zhongke Yinyi Property Management Co., Ltd. Health Center violated diagnostic norms and included non-reimbursable medical expenses, leading to a loss of 362,700 yuan. The center was ordered to return the funds and pay a fine of 362,700 yuan [7] Group 2: Other Violations - Beijing Beiya Orthopedic Hospital's Western medicine practitioners illegally prescribed traditional Chinese medicine decoctions without the necessary qualifications, resulting in the recovery of over 7.84 million yuan for the improperly prescribed items [8]