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医保卡变“购物卡”?央视曝光大参林、海王星辰等“套”刷医保卡黑链条
Yang Shi Wang· 2025-11-12 07:52
(央视财经《财经调查》)今年早些时候,全国多地医保局陆续发布了"禁止将医保卡变为'购物卡'"的 预警提示。提示中明确提到,部分企业为了使商品可以刷医保个人账户进行支付,将牙刷、面膜等非医 疗作用的产品申请为医疗器械,以此规避生活用品类不能刷医保卡的问题。这种行为违反了医保个人账 户资金的正当使用规定,医保个人账户资金专款专用,仅限医疗相关支出,骗保行为将面临法律惩戒。 但记者的调查显示,时至今日,这样的违法行为,依然在一些地区的药店和生产企业里上演。 在海王星辰连锁药店锦绣半岛店,记者刷医保卡买到了属于第一类医疗器械的"牙科用毛刷"。经过店员 证实,这款医疗器械其实与普通牙刷无异,由于被纳入了医保支付范围,所以名称不一样。 日用品"穿"上医疗器械"马甲" 部分药店明目张胆宣传"可刷医保" 近期有消费者向《财经调查》栏目反映,有人在网络平台上放出"医保卡薅羊毛攻略",公然分享在药店 里刷医保卡购买日常生活用品的经验。 根据《中华人民共和国社会保险法》第二十八条可以明确,基本医疗保险基金只能用于支付参保人员的 医疗相关费用。 而视频中的博主们却在纷纷教唆消费者,在完全脱离医疗场景的情况下使用医保卡支付购买牙线、牙 ...
医保卡变“购物卡”?总台《财经调查》曝光“套”刷医保卡黑链条→
Sou Hu Cai Jing· 2025-11-09 12:14
Core Viewpoint - The article highlights the ongoing misuse of medical insurance cards in China, where non-medical products are being fraudulently classified as medical devices to allow consumers to purchase them using their insurance funds, despite regulations prohibiting such practices [1][3][5]. Group 1: Misuse of Medical Insurance Cards - Various stores are openly promoting the ability to use medical insurance cards for purchasing everyday items like toothbrushes and skincare products, which are not intended for medical use [3][7]. - Consumers have reported finding guides online that instruct them on how to exploit their insurance cards for non-medical purchases [3][7]. - The Chinese Social Insurance Law explicitly states that medical insurance funds should only be used for medical-related expenses, yet violations continue to occur [5]. Group 2: Specific Examples of Misclassification - In multiple pharmacies, items such as dental cleaning devices and "medical toothbrushes" are sold, which are essentially regular products but labeled differently to qualify for insurance payments [9][10]. - A pharmacy in Chengdu allowed the purchase of contact lenses labeled as medical devices, despite official confirmation that they should not be eligible for insurance payment [12][14]. - Products like sunscreen sleeves and masks are being marketed as "medical isolation pads" to enable insurance payment, despite their actual use being for sun protection [22][23][33]. Group 3: Company Practices and Financial Implications - Companies are taking advantage of the loophole by branding everyday items as medical devices, thus increasing their market share and profits, with one company reporting a contract worth 90 million yuan for such products [29][31]. - The practice of selling "medical skincare products" in pharmacies is prevalent, with companies reporting significant sales figures, indicating that a large portion of their revenue comes from insurance payments [37][45][53]. - In one case, a company revealed that approximately 60% of its sales in a specific region were made using medical insurance cards, amounting to around 6 million yuan being drawn from consumer insurance funds [53].