At the beginning of this year, a medical insurance bureau in Shanghai received a report that the woman Ge Mou had repeatedly embezzled other people's medical insurance cards, dispensed drugs and sold them to drug dealers, making profits from them.
According to Ge Mou, who has retired, the drugs she sold are very new, even the packaging box is complete, once opened, others will not want it.
She would rather take less medicine herself and sell more to make money, which can be described as "asking for money and not dying".
In order to avoid being discovered by doctors, Ge often dispensed drugs across regions and was tired to the point of running and breaking his leg.
She also targeted the elderly who lived in a nursing home with her father, often sent fruit to the elderly, and the old people nagged at home, and after getting closer, said to help them dispense medicines and reduce the burden, in fact, it was "borrowing" the medical insurance cards of the elderly and selling the drugs.
At present, Ge mou has been controlled by the public security organs.
The Regulations on the Supervision and Administration of the Use of the Medical Security Fund, issued on May 1, clearly stipulate that when helping others to purchase drugs on behalf of others, in addition to showing the client's medical insurance card, they must also show the client's ID card and the buyer's ID card, and the identity and information will be verified and recorded. When the frequency, variety and actual demand of the drug do not match, the early warning system is triggered.
Therefore, when purchasing on behalf of others, fictitious medical services and more prescriptions of drugs are all insurance frauds.
After the insurance fraud, the insurance fund obtained by fraud must be returned in its entirety, and then a fine of more than 2 times and less than 5 times the amount of the fraud will be imposed.
For example, when Xiao Zhang's mother went through the hospitalization procedures, she used his medical insurance card and was reimbursed 3,000 yuan after discharge, which was fined at least 6,000 yuan and fined up to 15,000 yuan.
The theft of other people's medical insurance cards like Ge Mou is more serious, not only will he be fined, but he may also face criminal penalties.
In April, news that personal accounts could be shared with family members blew up the circle of friends, and many people misunderstood the policy and thought that the medical insurance card could be lent to others.
In fact, this is completely different, medical insurance reform, but the provisions of personal accounts can be tied to the family's account, hospital reimbursement, or have to use their own medical insurance card.
The medical insurance fund is an important foundation of China's resident medical security system, and is the people's medical treatment money and life-saving money, but some lawbreakers always play small tricks to exploit loopholes and defraud the national medical insurance fund.
In 2019, when a health center in Nandan County investigated the medical treatment of poor households, it was found that the poor household Luo Mou worked in Guangdong all year round and only returned home during the New Year, but the local hospital had three hospitalization records, and a total of more than 40,000 yuan was reimbursed.
After the medical insurance department reported to the police, according to Luo's confession, her brother's wife was sick, but there was no medical insurance, in order to reduce the cost, let the sister-in-law take her identity information in the hospital for treatment, follow-up reimbursement is also her medical insurance.
In the end, Luo was criminally detained by the police, and he also needed to return the more than 40,000 yuan of medical insurance funds he had defrauded.
This is a typical good intention to do bad things, Luo Mou's sister-in-law, did not pay the medical insurance fee, then the medical insurance fund pool does not have her share, can not be reimbursed is normal.
The behavior of Luo Mou and his sister-in-law is unfair to other people who have paid for medical insurance. When you are sick, because you are in a hurry because you have no medical insurance, what do you usually do?
Now the cost of medical treatment is too expensive, an ordinary family, hard work for decades can only save more than a hundred and twenty thousand, but if someone in the family is seriously ill into the ICU, it does not take a week, this money will all be used up.
Many risk-conscious people, in addition to health insurance, will also buy commercial insurance. If you have such a plan, you should not just lend your health insurance card to someone else, not even your parents.
Otherwise, the parents' illness will be recorded on the owner of the health insurance card. Inadvertently, it will cause the fact that the insurance company will buy insurance with illness, and the insurance company may use this as a reason to refuse to compensate, and the money for the insurance will be spent in vain.
Medical insurance facilitates our lives, but it does not mean that we can use our own medical insurance cards, because medical insurance cards also have strong national public welfare attributes, and it does not belong entirely to individuals.
If the family does not have a job, they can pay social security as flexible workers, or buy a new rural cooperative, rather than lending them a medical insurance card to use.
What do you think of the news?