Focusing on medical imaging examination, clinical testing, and rehabilitation fields, medical insurance fund flight inspection is launched again
2023-10-25
On October 23, the 20th launch meeting of the National Medical Security Fund's flight inspection in 2023 was held in Xiamen, Fujian. According to the deployment of the National Medical Insurance Bureau, a flight inspection team composed of the Hebei Provincial Medical Insurance Bureau, the Department of Finance, and the Health Commission will conduct an inspection of two designated medical institutions, one designated retail pharmacy, and the municipal medical insurance center in Xiamen for about 10 days. The medical insurance fund is the 'medical money' and 'life-saving money' of the people, and it is the 'ballast stone' for improving people's well-being and maintaining social harmony and stability. Maintaining the safety of the medical insurance fund is a common political responsibility of the medical insurance department and designated medical institutions, a specific measure to firmly promote comprehensive and strict governance of the Party, and a necessary requirement for the high-quality development of medical institutions. "Gu Rong, Deputy Director of the Fund Supervision Department of the National Medical Insurance Bureau, introduced that starting from 2019, The National Medical Insurance Administration has begun exploring the establishment of a medical insurance fund flight inspection mechanism. As of the end of September this year, a total of 203 flight inspection teams have been organized, with a total of 433 designated medical institutions inspected and medical insurance funds recovered of 3.1 billion yuan. "Flight inspections have become a sharp tool for cracking down on illegal and irregular issues in the medical insurance field." It is understood that the 2023 National Medical Insurance Fund flight inspection will start in August this year, covering 31 provinces, regions, cities, and Xinjiang Production and Construction Corps across the country, And for the first time, designated retail pharmacies were included in the inspection target. As of now, flight inspection work has been carried out in 19 provinces and cities, including Guizhou, Shaanxi, Sichuan, Xinjiang, and Shanghai. Many provinces have also carried out provincial-level flight inspections in accordance with the national model. According to the Implementation Opinions on Strengthening the Normalization Supervision of the Use of Medical Security Funds issued by the State Administration, it is necessary to promote the normalization of flight inspections. In the future, the random sampling scope will cover all coordinated regions of the country, as well as various types of designated medical insurance institutions at all levels. At the kickoff meeting, after public lottery, Xiamen Medical Insurance Fund's top ranked hospitals, including Xiamen University Affiliated Zhongshan Hospital and Xiamen Hong'ai Rehabilitation Hospital, as well as Xiamen Binnan Pharmacy of China National Pharmaceutical Holdings Fujian Co., Ltd., were identified as the tested units. This flight inspection focuses on three key areas: medical imaging examination, clinical testing, and rehabilitation, covering the use and management of medical insurance funds from January 1, 2021 to December 31, 2022. The night before the launch meeting, Li Shengqun, the leader of the flight inspection team and the deputy secretary and deputy director of the Hebei Medical Insurance Bureau, deployed the flight inspection work and proposed inspection requirements, clarifying the division of labor among all parties. We will focus on the internal control and financial management of medical insurance in designated pharmaceutical institutions, as well as the centralized procurement and execution of drugs and consumables. Whether designated retail pharmacies collude with medical insurance drugs or other products that are not paid for by medical insurance funds, empty or stolen medical insurance vouchers, forge or alter medical insurance drug 'purchase, sales, and storage' invoices and accounts, forge prescriptions or expense lists of insured personnel, and other behaviors Institutions should focus on inspecting and verifying the fees and settlement payments of designated medical institutions, identifying the treatment of chronic and special diseases in outpatient clinics, admitting designated medical institutions, reviewing the settlement of medical expenses in other places, and using intelligent audit systems Li Shengqun said. After the on-site inspection lasting about 10 days, the flight inspection team will communicate and provide feedback with the inspected unit, Xiamen Medical Insurance Bureau, and Fujian Medical Insurance Bureau
Edit：Wang Chen Responsible editor：Jia Jia
Source：www.ccdi.gov.cn
Special statement: if the pictures and texts reproduced or quoted on this site infringe your legitimate rights and interests, please contact this site, and this site will correct and delete them in time. For copyright issues and website cooperation, please contact through outlook new era email：lwxsd@liaowanghn.com
Recommended Reading Change it 
Home
