Law

Providing "empty swipe" of medical insurance card is identified as fraud, a warning lesson

2022-12-08   

As long as the medical insurance card is put in the pharmacy, it is not only free to dispense medicine, but also can take oil, rice and red packets. However, the price of "small gains" is punishment. According to the report of Qianjiang Evening News on December 5, the West Lake Court in Hangzhou, Zhejiang, recently heard a case. The defendant, Mr. Yu, provided his medical insurance card for others to use. In four years, he cheated the national medical insurance fund of nearly 150000 yuan, and Mr. Yu earned 15000 yuan, In the end, the West Lake Court sentenced Mr. Yu to one year and six months' imprisonment, two years' probation, and a fine of 15000 yuan for fraud. The medical insurance fund is a special fund set up by the state to protect people's basic medical care, which is a "life-saving money". If everyone, like Yu in the above case, takes the medical insurance card as a tool for making profits, the consequences will be unimaginable. Therefore, from a certain perspective, the above judgment of the court is to give the public a legal lecture. For a long time, many people have been under the misconception that "the medical insurance card is all their own money, not for nothing", so some people regard the medical insurance card as a shopping card, while others, like Mr. Yu, conspire with others to arbitrage without interest, and they are not very clear that these behaviors are already illegal use of medical insurance cards. In fact, when swiping the medical insurance card, people will not only use the fees paid by individuals, but also use the fees allocated by the medical insurance fund as a whole. That is to say, illegal use of the medical insurance card will lead to the loss of national medical insurance funds, causing chaos in the card use order, and thus damaging the public's rights and interests. Of course, the above cases also exposed some loopholes in the management of medical insurance cards. It is reported that the employees of the drugstore involved in the above incident used several others' medical insurance cards in the same way to defraud the national medical insurance fund. It is not difficult to see that some designated medical insurance pharmacies do not act in accordance with laws and regulations in the use of medical insurance cards, but "encourage" and encourage fraudulent use in pursuit of interests. At the same time, fraud involving medical insurance funds is often highly professional and covers a wide range of areas, while the relevant regulatory departments are short of personnel and have heavy tasks, which makes it impossible to avoid fraud and other phenomena, resulting in the loss of medical insurance funds. In order to further organize the "safety net" of the medical insurance fund and protect the "life-saving money" of the people, the National Health Insurance Bureau and the Ministry of Finance recently jointly formulated the "Rewards for Reporting Illegal Use of Medical Security Fund", which will be officially implemented on January 1, 2023. This method clearly stipulates that the whistleblowers who use the medical insurance fund illegally will be given a one-time reward at a certain proportion, which will help guide and encourage the masses to participate in social supervision, make up for the weaknesses in supervision, and thus improve the safety factor of the medical insurance fund. Compared with ex post facto accountability, the fight against insurance fraud still needs to move forward. The relevant departments should strengthen the publicity of the medical insurance system, policies and cases, guide the insured people to use the medical insurance card correctly according to laws and regulations, and let people establish the awareness that "life saving money" cannot be misused and offenders will be punished. At the same time, it is necessary to strictly regulate the operation of medical insurance service institutions, improve the regulatory mechanism, broaden the supervision channels, have zero tolerance for illegal sales of non medical insurance products, cash out transactions with medical insurance cards, empty and stolen personal account funds, and transfer suspected crimes to the judicial authorities in accordance with the law, so as to increase the cost of violations. The public should also bear in mind that small gains are costly. (Look at Xinshi

Edit:sishi Responsible editor:xingyong

Source:https://www.chinanews.com/sh/

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