In order to crack down on illegal and illegal behaviors in the field of medical insurance, effectively safeguard the safety of medical insurance funds, and protect the health rights and interests of citizens, recently, the State Medical Insurance Bureau, the Ministry of finance, the national health and Health Commission, and the State Administration of traditional Chinese Medicine decided to organize the 2022 medical insurance fund flight inspection nationwide, and formulated the 2022 medical insurance fund flight inspection work plan (hereinafter referred to as the work plan). According to the work plan, the objects of this inspection are designated medical institutions and medical insurance agencies at the county and district levels throughout the country, and the relevant institutions and participants can be extended as appropriate. In principle, the institutions that have previously accepted the national flight inspection will no longer be the object of this inspection. The inspection period is from January 1, 2020. The inspection contents include the medical service behaviors and medical expenses (including the settlement expenses of local receiving cross provincial and non local medical personnel) included in the payment scope of medical security funds in the fields of hemodialysis and high-value medical consumables (orthopedics and Cardiology) of designated medical institutions, the performance of service agreements and the audit and settlement payment of expenses of medical insurance agencies The behavior of defrauding medical insurance funds by fictitious medical service projects and other means shall be examined. The participating and inspected provinces are determined by drawing lots, including Beijing, Tianjin, Shanghai and Chongqing. In addition, the National Medical Insurance Bureau will organize teams to carry out special flight inspections on relevant institutions according to work needs. The inspection time of each group shall be controlled within 10 days. According to the administrative measures for flight inspection of medical security funds (Draft for comments) issued by the State Medical Security Bureau on December 1, 2021, flight inspection refers to the on-site supervision and inspection organized and implemented by the national and provincial medical security administrative departments to the designated medical institutions, medical insurance agencies, other institutions undertaking medical insurance business and other inspected objects without prior notice. Previously, the State Medical Security Bureau released the flight inspection of medical insurance funds in 2021. The medical institutions at the verified points had problems in medical insurance management, repeated charges and other violations of laws and regulations, and were suspected of illegally using the medical insurance funds of 503 million yuan. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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