Original title: Yunnan First County Hospital Punished for Illegal Use of Medical Insurance Fund
CAMCE News (Worker's Daily - CAMCE reporter Zhao Lihao) A reporter learned from the "Credit China" website that Luoping County People's Hospital in Qujing City, Yunnan Province was fined 622700 yuan by Luoping County Medical Security Bureau on May 30. It is understood that the hospital has violated the medical clinical diagnosis and treatment norms and medical insurance related policies due to the problems of no pointer charging, cross charging, decomposition charging, etc.
Public information shows that Luoping County People's Hospital integrates medical treatment, teaching, scientific research, prevention, health care, rehabilitation, first aid and medical care. It will be promoted to a tertiary hospital in 2020. The hospital will strive to build a medical and health service center in the junction of three provinces and regions (Yunnan, Guangxi and Guizhou).
The reporter noticed that Luoping County People's Hospital had been punished many times before. On March 31, 2020, the Medical Insurance Bureau of Yunnan Province reported eight typical cases of fraud, including the case of fraudulent use of the treatment of the registered poor to defraud medical insurance funds.
After investigation, the hospitalized patient Gao was taken back by his family after a fall in Guangdong and sent to Luoping County People's Hospital for spinal trauma surgery for hospitalization. He did not participate in the medical insurance for urban and rural residents, and pretended to be hospitalized by using the household register and health poverty alleviation service card of Yin, a registered poverty-stricken population in the village.
As Luoping County People's Hospital did not strictly control the medical identity of patients, the medical insurance department deducted 68200 yuan of the illegal expenses of Luoping County People's Hospital, recovered 273000 yuan of liquidated damages based on four times of the illegal expenses, and ordered Gao to return 19700 yuan of the medical insurance fund defrauded.
In September 2023, Luoping County Medical Security Bureau reported cases of medical insurance violations, and Luoping County People's Hospital was fined 758500 yuan for illegal use of medical insurance funds.
It is reported that from March 14 to March 23, 2023, Luoping County Medical Security Bureau found in its daily supervision that Luoping County People's Hospital used medical insurance funds in violation of regulations. It was found that the hospital illegally used medical insurance funds in such ways as overcharging, repeated charging, decomposition charging, and over indication charging, involving 944500 yuan. Luoping County Medical Security Bureau ordered Luoping County People's Hospital to carefully check and rectify the existing problems according to relevant laws and regulations; He was ordered to return the medical insurance fund used in violation of regulations, and was fined 758500 yuan.
