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倒卖药品、伪造材料…… 5起骗保案接连公开
Jin Rong Shi Bao· 2025-12-02 11:22
Core Viewpoint - The National Medical Insurance Administration has revealed five typical cases of individuals fraudulently obtaining medical insurance funds, involving illegal activities such as the resale of medical drugs and the fabrication of proof materials [1] Group 1: Types of Fraud - The fraudulent activities include both the resale of medical drugs by insured individuals and the use of false proof materials to claim medical reimbursements [1] - Specific cases highlight individuals exploiting special disease treatments and low-income insurance benefits to illegally profit from excess prescriptions [1] Group 2: Case Summaries - In Hebei Province, an individual named Guan collected over 70 social security cards to fraudulently claim over 120,000 yuan in medical reimbursements by purchasing and reselling a drug called Semaglutide [2] - In Anhui Province, a person named Xiao exploited his low-income insurance status to fraudulently claim 51,950.91 yuan by selling excess medication prescribed for his condition [3] - In Henan Province, Zhang was found to have fabricated injury details to claim 39,477.26 yuan in reimbursements, leading to criminal charges and penalties [4] - In Shandong Province, Wang and his accomplices were involved in a scheme to misrepresent a work-related injury as a home accident, resulting in a fraudulent claim of 18,070.63 yuan [5][6] - In Liaoning Province, Liu was implicated in a case where he misrepresented a traffic accident to claim 6,549.11 yuan from the medical insurance fund, with the case currently under investigation [7]
国家医保局公布5起个人骗取医保基金典型案例
Zhong Guo Xin Wen Wang· 2025-12-01 06:41
Core Viewpoint - The National Healthcare Security Administration (NHSA) has released five typical cases of individuals fraudulently obtaining medical insurance funds to strengthen legal awareness and deter fraudulent activities in the healthcare system [1] Group 1: Case Summaries - Case 1: In Qinhuangdao, Hebei Province, an individual named Guan and four accomplices collected over 70 social security cards to fraudulently claim over 120,000 yuan from medical insurance by purchasing and reselling a drug called Semaglutide [2] - Case 2: In Wuhu, Anhui Province, an individual named Xiao exploited his medical condition to fraudulently obtain and sell excess medication, resulting in a total fraud of 51,950.91 yuan [3] - Case 3: In Zhengzhou, Henan Province, Zhang falsified injury details to claim 39,477.26 yuan from medical insurance, despite already receiving compensation from his employer for a work-related injury [4] - Case 4: In Yantai, Shandong Province, Wang and two accomplices misrepresented a work-related injury as a home accident to fraudulently claim 18,070.63 yuan from medical insurance [5][6] - Case 5: In Benxi, Liaoning Province, Liu was involved in a traffic accident and falsely reported the circumstances to claim 6,549.11 yuan from medical insurance, leading to criminal charges [7] Group 2: Legal Consequences and Warnings - All individuals involved in these cases faced criminal penalties and were required to fully repay the fraudulently obtained medical insurance funds, highlighting the serious legal repercussions of such actions [8] - The NHSA emphasizes the importance of adhering to healthcare laws and regulations, urging the public to resist the temptation of fraud and to report any suspicious activities to protect the integrity of the medical insurance system [8]
国家医保局发布个人骗取医保基金典型案例
Ren Min Wang· 2025-12-01 01:59
Core Viewpoint - The National Medical Insurance Administration emphasizes the importance of safeguarding the medical insurance fund and has released five typical cases of individual fraud to strengthen legal awareness and deter fraudulent activities [1] Group 1: Case Summaries - Case 1: In Qinhuangdao, Hebei, an individual named Guan and four accomplices collected over 70 social security cards to fraudulently obtain 120,000 yuan in reimbursements for a drug, which they then sold in other provinces [2] - Case 2: In Wuhu, Anhui, an individual named Xiao exploited his medical condition to obtain excess medication, selling the surplus for a total fraud of 51,950.91 yuan [3] - Case 3: In Zhengzhou, Henan, Zhang falsified injury details to claim 39,477.26 yuan in reimbursements after already receiving compensation from his employer for a work-related injury [4] - Case 4: In Yantai, Shandong, Wang and two accomplices misrepresented a work-related injury as a home accident, resulting in a fraudulent claim of 18,070.63 yuan [5][6] - Case 5: In Benxi, Liaoning, Liu misrepresented a traffic accident to claim 6,549.11 yuan from the medical insurance fund, which was ultimately recovered [7] Group 2: Fraud Patterns and Consequences - The five cases illustrate two main types of fraud: selling medical drugs and falsifying documentation to claim reimbursements [8] - All individuals involved faced criminal penalties and were required to fully repay the defrauded medical insurance funds, highlighting the serious legal repercussions of such actions [8] - The National Medical Insurance Administration warns the public against engaging in fraudulent activities, stressing the importance of adhering to medical insurance laws and protecting personal rights [8]
国家医保局发布个人骗取医保基金典型案例(第四期)
Yang Shi Wang· 2025-12-01 01:32
Core Viewpoint - The National Healthcare Security Administration emphasizes the importance of safeguarding the medical insurance fund, highlighting a zero-tolerance policy towards fraud and misuse of these funds [1] Group 1: Case Summaries - Case 1: In Qinhuangdao, Hebei, an individual named Guan and four accomplices collected over 70 social security cards to fraudulently claim over 120,000 yuan in reimbursements for a drug, which they then sold across multiple provinces [2] - Case 2: In Wuhu, Anhui, a participant named Xiao exploited his medical condition to obtain excess medication, selling the surplus for a total fraud amount of 51,950.91 yuan [3] - Case 3: In Zhengzhou, Henan, Zhang falsified injury details to claim 39,477.26 yuan in reimbursements after already receiving compensation from his employer for a work-related injury [4] - Case 4: In Yantai, Shandong, Wang and two others conspired to misrepresent a work-related injury as a home accident, resulting in a fraudulent claim of 18,070.63 yuan [5] - Case 5: In Benxi, Liaoning, Liu misrepresented a traffic accident to claim 6,549.11 yuan from the medical insurance fund, which was determined to be the responsibility of a third party [6] Group 2: Legal Consequences and Warnings - All individuals involved in the fraud cases faced criminal charges and were required to fully repay the misappropriated medical insurance funds, underscoring the serious legal repercussions of such actions [7] - The article warns the public against engaging in fraudulent activities, emphasizing the importance of adhering to healthcare laws and protecting personal medical insurance rights [7]