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临沂发布4例违法违规使用医保基金案例
Qi Lu Wan Bao Wang· 2025-08-13 16:14
Core Viewpoint - The Linyi City medical insurance departments are intensifying the regular supervision of medical insurance fund usage, cracking down on fraudulent activities, and ensuring the safety of the medical insurance fund by publishing four cases of illegal fund usage [1] Group 1: Case Summaries - Linyi Lanshan Li Guan Nursing Home was found to have fabricated medical documents leading to a medical insurance fund expenditure of 2,487.19 yuan and falsely created medical service items costing 12,530.89 yuan, resulting in a total of 15,018.08 yuan to be returned and a fine of 30,036.16 yuan [2] - Linyi Lanshan Zao Yuan Nursing Home engaged in similar fraudulent activities, with a total medical insurance fund expenditure of 23,955.74 yuan from forged documents and 3,588.88 yuan from fictitious services, requiring a return of 27,544.62 yuan and a fine of 55,089.24 yuan [3] - An individual named Wang was found to have forged outpatient prescriptions to claim high-value drugs, defrauding the medical insurance fund of 7,990.85 yuan, which must be returned along with a fine of 15,981.70 yuan [4] - Linyi Yushi Rehabilitation Medical Center was involved in overcharging, duplicate billing, and violating treatment norms, with a total of 127,290.14 yuan in improper medical insurance fund usage that needs to be rectified [5]