According to the Anhui Provincial Medical Security Bureau, at noon today (December 3), the bureau issued a notice on the illegal use of medical insurance by the Second People's Hospital of Wuhu City. After investigation, the Second People's Hospital of Wuhu City had problems such as excessive diagnosis and treatment, excessive inspection, over-prescribing drugs, repeated charges, applied charges, and over-standard charges, involving the total cost of illegal medical treatment21.820,000 yuan。The full text of the notification is as follows: On July 18, 2023, our bureau received a petition report from Yang Moumou, reflecting that the Second People's Hospital of Wuhu City used medical insurance in violation of laws and regulations during his father's hospitalization due to cerebral hemorrhage through fictitious and collusive exchange of diagnosis and treatment services**. Our bureau attaches great importance to it, and on the basis of doing a good job in data screening and analysis, on August 8, a provincial and municipal joint inspection team of more than 20 people was formed with the Wuhu Municipal Medical Insurance Bureau to enter the hospital to conduct a comprehensive verification of the hospital charges and medical insurance reimbursement during the hospitalization of the whistleblower's father. Through medical record verification, on-site inquiry, data comparison, etc., it was verified that 10 of the 15 problems involved in the report were basically true. After investigation,The hospital has problems such as excessive diagnosis and treatment, excessive examination, over-prescribing drugs, repeated charges, applied charges, and over-standard charges, involving the total cost of illegal medical treatment.21820,000 yuan, of which 18700,000 yuan. In order to maintain the safety of medical insurance and protect the legitimate rights and interests of patients, according to the medical insurance service agreement signed between the hospital and the Wuhu medical insurance department, the Wuhu Municipal Medical Insurance Bureau first handled it according to the agreementThe first is to recover the full amount of the medical insurance ** used in violation of regulations, and deduct the penalty of 56,074 according to the 30% ceiling41 yuan;The second is to interview the relevant person in charge of the hospital and order him to immediately rectify the situationThird, they were handed over to the public security and health departments for further verification and handling. At present, all the above treatment measures have been completed. At the same time, the Wuhu Municipal Medical Insurance Bureau has initiated the administrative penalty procedure in accordance with the "Regulations on the Supervision and Administration of the Use of Medical Security". While verifying the reported issues, the provincial and municipal joint inspection teams drew inferences from one case to another, and conducted a comprehensive extended inspection of the hospital's use of medical insurance** from April 1, 2022 to May 31, 2023. On September 25, the Wuhu Municipal Medical Insurance Bureau gave written feedback to the whistleblower in the form of a regulatory notice in accordance with the "Implementation Rules for the Handling of Reporting Clues for the Supervision and Management of Medical Security in Anhui Province (Trial)". In accordance with the "Anhui Provincial Illegal Use of Medical Security** Reward Measures".5364 to the whistleblower04 yuan reward for reporting. Editor: Zhao Linyue.
Editor: Xie Wenjuan.
Producer: Liu Jinglin.
Director: Zhu Guanglun.
Source: Anhui Provincial Medical Security Bureau's official WeChat, Red Star News, Nanfang *** Jingchu Network.
Submission email: bjtvysbj@163com