Core Points - The National Healthcare Security Administration (NHSA) has reported multiple cases of fraudulent claims for maternity insurance funds, highlighting serious violations of regulations and public interest [1][2][3][4] - Companies are found to be engaging in practices such as fictitious employee registrations and inflated insurance payment bases to exploit maternity benefits [2][3][4] Group 1: Fraudulent Cases - In Kunming, a company registered 30 employees, with 24 claiming maternity benefits totaling 2.271 million yuan, all of whom transferred to the company just 2-3 months before childbirth [2] - In Quanzhou, a consulting firm had an abnormal increase in insured individuals, with 4 employees fraudulently claiming 71,000 yuan in maternity benefits through fictitious labor relationships [2] - In Zhangjiakou, two companies were found to have employees who claimed maternity benefits while not actually working there, totaling 507,000 yuan in fraudulent claims [3] Group 2: Abnormal Insurance Practices - A company in Deyang reported employees who joined the company only after becoming pregnant, with their insurance payment bases being five times higher than the company’s average [4] - The NHSA emphasizes the importance of providing accurate and truthful information when applying for maternity benefits to safeguard the integrity of the maternity insurance fund [1][4]

Core Viewpoint - The National Healthcare Security Administration emphasizes the importance of maternity insurance in protecting the rights of insured individuals and maintaining fairness in employment, while highlighting the serious issue of fraudulent claims that disrupt the management of maternity insurance funds [1][2]. Group 1: Fraud Cases - Case 1: Yunnan Tongsheng Tea Trade Co., Ltd. was found to have 30 employees registered, with an average monthly contribution base of over 17,000 yuan. 24 employees claimed maternity benefits totaling 2.271 million yuan, with suspicious activity of transferring insurance shortly before childbirth [1]. - Case 2: Two companies in Zhangjiakou, Hebei, were discovered to have fabricated labor relationships, leading to 50.7 million yuan in fraudulent maternity benefits claimed by employees who were not actually working [3][4]. - Case 3: Chao Yi Tax Consulting Co., Ltd. in Fujian was found to have four employees falsely claiming maternity benefits totaling 71,000 yuan, resulting in criminal convictions for the company's representatives [5]. - Case 4: Dayu Hongyi Decoration Design Co., Ltd. in Jiangxi was found to have inflated the contribution base for two employees, leading to a fraudulent claim of 84,000 yuan in maternity benefits [6]. - Case 5: Sichuan Hongyu Chunfan Agricultural Co., Ltd. was flagged for suspicious claims of 229,000 yuan in maternity benefits by employees who joined the company after becoming pregnant, raising concerns about the legitimacy of their employment [8].

来源：央视新闻客户端 生育保险作为社会保险体系的重要组成部分，对维护参保人合法权益、促进就业公平、均衡用人单位负 担具有重要作用。但个别参保单位和参保人法律意识淡薄，通过虚构、编造参保人信息，虚构劳动关系 等参加生育保险；未依法如实申报生育保险缴费基数；伪造、变造病历、票据等申领材料骗取生育保险 基金，严重扰乱生育保障管理秩序，侵害了公共利益和基金安全，依法依规应予以严肃处理。 为发挥警示教育作用，国家医疗保障局曝光台今天公布5起骗取生育保险基金的典型案例，以此提醒广 大参保单位和参保人，通过合法途径参加生育保险，提供真实、准确、完整的申报材料申领生育津贴和 生育医疗费，共同维护生育保险基金安全。 （原标题：骗取生育保险基金 主犯获刑十年！国家医保局曝光典型案例） 广西壮族自治区贵港市港北区枫达食品配送中心等2家参保单位骗取生育保险基金案 案例一 湖北省大冶市禾顺人力资源有限公司骗取生育保险基金案 湖北省大冶市医保局在线索核查时发现，大冶市禾顺人力资源有限公司于2020年7月起参加职工基本医 疗保险（含生育保险），截至2022年11月累计参保189人，参保人员中住院分娩发放生育津贴127人。经 查，该公司涉嫌 ...

Core Viewpoint - The article highlights the importance of maternity insurance as a crucial part of the social insurance system, emphasizing the need for compliance and the consequences of fraudulent activities that undermine the integrity of the maternity insurance fund [3]. Group 1: Fraud Cases - A case involving Heshun Human Resources Co., Ltd. in Daye City, Hubei Province, revealed that the company fabricated labor relationships to pay for medical insurance for pregnant women not covered by insurance, resulting in a fraud of 2.4916 million yuan [4][5]. - In Qiqihar City, Heilongjiang Province, three companies were found to have falsified labor contracts and payrolls, leading to the recovery of 260,200 yuan in misappropriated maternity benefits [6][7]. - In Guangxi Zhuang Autonomous Region, two companies were discovered to have submitted inflated salary claims to fraudulently obtain maternity benefits totaling 70,090.69 yuan [8][9]. - A case in Anshan City, Liaoning Province, involved individuals fabricating employment documents to claim maternity benefits of 18,803.37 yuan, which were subsequently recovered [10][11]. - In Shanghai, an individual was found to have forged medical documents to claim maternity benefits of 62,725.9 yuan, which were also recovered [12][13]. Group 2: Regulatory Actions - The National Medical Insurance Administration has taken steps to expose fraudulent activities and remind participants to provide accurate information when applying for maternity benefits [3]. - Law enforcement agencies have been actively involved in investigating and prosecuting individuals and companies involved in these fraudulent schemes, ensuring that misappropriated funds are returned to the maternity insurance fund [7][9][11][13].

Core Viewpoint - The article emphasizes the importance of maternity insurance as a crucial part of the social insurance system, highlighting issues of fraud and the need for legal compliance among insured units and individuals [1] Group 1: Fraud Cases - Case 1: Hubei Province's He Shun Human Resources Co., Ltd. was found to have fabricated labor relationships to pay for medical insurance for non-insured pregnant women, resulting in a fraud of 2.4916 million yuan [2] - Case 2: Three companies in Heilongjiang Province were identified for falsifying labor contracts and payrolls, with the actual operators being involved in a scheme to profit from maternity insurance claims [3] - Case 3: In Guangxi Province, two companies were found to have reported inflated salary bases to claim maternity benefits, amounting to 70,090.69 yuan [5] - Case 4: In Liaoning Province, an individual conspired to create false employment documents to claim maternity benefits of 18,803.37 yuan [7] - Case 5: A participant in Shanghai was discovered to have submitted forged medical records to claim maternity benefits totaling 62,725.9 yuan [10] Group 2: Legal Actions and Recoveries - In the Hubei case, the main perpetrator received a ten-year prison sentence, and the total amount of fraud was referred to law enforcement for further action [2] - In the Heilongjiang case, 26,020 yuan of misappropriated maternity benefits was recovered, and arrests were made [4] - In the Guangxi case, the misappropriated maternity benefits were also recovered, and the main suspects were sent for prosecution [6] - In the Liaoning case, the fraudulently claimed maternity benefits were recovered, and the case was forwarded to the prosecution [8] - In the Shanghai case, the fraudulent amount was returned to the maternity insurance fund, and administrative penalties were imposed [10]

国家医保局曝光5起骗取生育保险基金典型案例 案例三 广西壮族自治区贵港市港北区枫达食品配送中心等2家参保单位骗取生育保险基金案 广西壮族自治区贵港市医保局在日常检查中发现，贵港市港北区枫达食品配送中心、港北区健记鲜肉配 送中心成立以来，为3名雇员在生育分娩的几个月内申报并缴纳医疗保险(含生育保险)，申报基数最高 达到18000元，明显高于当地同类岗位工资5000元的平均水平，且未缴纳任何人员的其他社会保险，存 在骗取生育津贴嫌疑。经查，2家公司涉嫌通过伪造证明材料、虚构薪资、虚报社保缴纳基数等欺诈骗 取生育津贴，涉及金额70090.69元。公安机关对该起案件立案侦查，以上人员对其违法行为均供认不 讳。 目前，被侵占的生育津贴已追回，涉案的4名主要嫌疑人已移送检察机关起诉中。 中新网10月16日电 据"国家医保局"微信公众号消息，生育保险作为社会保险体系的重要组成部分，对 维护参保人合法权益、促进就业公平、均衡用人单位负担具有重要作用。但个别参保单位和参保人法律 意识淡薄，通过虚构、编造参保人信息，虚构劳动关系等参加生育保险；未依法如实申报生育保险缴费 基数；伪造、变造病历、票据等申领材料骗取生育保险基金，严重 ...