Recently, the provincial government issued the "Anhui Provincial Medical Security Fund Supervision and Management Measures", which clearly implements full-caliber supervision of medical insurance funds. The measures will come into effect on May 1.
The measures stipulate that when participating in insurance payment, employers shall not engage in the following acts: failing to go through the formalities of registration, payment or change of basic medical insurance for employees in accordance with regulations; untrue financial accounting statements, concealing or underreporting the total salary of employees or information on insured personnel; issuing false labor and personnel relations certificates; and intercepting or misappropriating the basic medical insurance premiums paid by insured personnel.
Insured persons shall not participate in basic medical insurance by means of falsifying household registration, student status, labor and personnel relations, or fraudulently using other people's information. They may not take advantage of their medical security benefits to resell medicines, accept the return of cash, in kind or obtain other illegal benefits.
Designated medical institutions shall establish an internal management system for the use of medical security funds, and upload relevant information on medical security in real time. When providing medical services, it is not allowed to decompose hospitalization or hang up beds for hospitalization; excessive diagnosis and treatment, excessive examination, illegal charging; collusion of drugs, consumables, and diagnosis and treatment items; induce or assist others to impersonate or falsely seek medical treatment or purchase drugs.
Medical insurance agencies shall establish mechanisms such as collective negotiation and consultation with designated medical institutions, sign service agreements with qualified designated medical institutions in accordance with the principles of equality, voluntariness and consensus, and promptly settle and disburse medical security funds.
According to the measures, the administrative department of medical insurance will impose administrative penalties in accordance with the law for violations of the above provisions, resulting in losses to the medical insurance fund. Those who defraud medical insurance funds by forging, altering, concealing, altering, destroying medical documents, medical certificates, accounting vouchers, electronic information, etc., or fabricating medical service items, will be investigated for criminal liability in accordance with law. (Zhu Linlin)
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The source | Anhui Daily
Responsible editor| Ding Li edited | He Wenyi
Organizer | Information Office of Anhui Provincial Government, Provincial Cyberspace Administration
Platform construction and technical support | Anhui New Media Group
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