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09:02:03</span> <span>來(lái)源：法治日?qǐng)?bào)</span>  <div id="8b2xws4kyi" class="icon-medium wrapper_1200 share"><span>分享：</span><a title="分享到微信" class="bshare-weixin" data-fx="wx-btn" data-spm-anchor-id="C94212.P4YnMod9m2uD.ENPMkWvfnaiV.11"></a></div> <span><i class="button">-</i><i>標(biāo)準(zhǔn)</i><i class="button">+</i></span> </div> </div> <div> <p style="text-indent: 2em; text-align: left; margin-bottom: 0px;">法治日?qǐng)?bào)北京1月23日訊記者董凡超記者今天從最高人民檢察院獲悉，2024年，全國(guó)檢察機(jī)關(guān)共起訴醫(yī)保騙保犯罪4700余人。檢察機(jī)關(guān)辦案發(fā)現(xiàn)，該類犯罪手段多樣、花樣翻新，嚴(yán)重侵害醫(yī)保基金安全，需綜合施策、深化治理。<br/></p><p style="text-indent: 2em; text-align: left; margin-bottom: 0px;">近年來(lái)，隨著國(guó)家醫(yī)療保障體系的健全完善，醫(yī)保覆蓋面和基金規(guī)模不斷擴(kuò)大，相關(guān)監(jiān)管風(fēng)險(xiǎn)點(diǎn)隨之增加。檢察機(jī)關(guān)辦案發(fā)現(xiàn)，涉案醫(yī)院往往以代付住院押金、免伙食費(fèi)、車接車送及現(xiàn)金返還等方式利誘參保人員住院，再以“小病大治”“無(wú)病假治”等手段虛構(gòu)診療項(xiàng)目，騙取醫(yī)保資金。此類案件往往持續(xù)時(shí)間長(zhǎng)、涉案金額大。在檢察機(jī)關(guān)辦理的王某某、康某某等27人詐騙、幫助毀滅證據(jù)等案中，某職工療養(yǎng)院、慈善醫(yī)院院長(zhǎng)王某某、副院長(zhǎng)康某某等發(fā)動(dòng)職工招攬有醫(yī)保的群眾并誘導(dǎo)其住院，通過(guò)虛假住院、偽造病歷、虛開(kāi)治療項(xiàng)目等手段虛報(bào)住院人次和費(fèi)用，騙取醫(yī)保資金4000萬(wàn)余元。</p><p style="text-indent: 2em; text-align: left; margin-bottom: 0px;">檢察辦案還發(fā)現(xiàn)，一些不法分子超量、重復(fù)開(kāi)藥倒賣，滋生醫(yī)保“回流藥”黑色產(chǎn)業(yè)鏈。一些不法分子專門收集他人醫(yī)保卡購(gòu)藥或誘導(dǎo)參保人員多開(kāi)藥品販賣牟利，形成“收卡-購(gòu)藥-收藥-賣藥”的非法套利鏈條。2024年以來(lái)，北京、上海、天津等多地均辦理“回流藥”類騙保案件。檢察辦案發(fā)現(xiàn)，醫(yī)保支付比例較高的老年群體、從事醫(yī)療護(hù)理服務(wù)的人員易被“藥販”拉攏發(fā)展成為“藥農(nóng)”，甚至“久病成藥販”。在檢察機(jī)關(guān)辦理的朱某甲等人詐騙、掩飾、隱瞞犯罪所得案中，10余名不法分子指使、教唆享有醫(yī)療保險(xiǎn)的老年人，到社區(qū)衛(wèi)生中心等醫(yī)療機(jī)構(gòu)違規(guī)、超量配藥，不法分子低價(jià)收購(gòu)后，將其分銷給外省市“藥商”，通過(guò)藥店、微信群等再次倒賣，涉案金額137萬(wàn)余元。</p><p style="text-indent: 2em; text-align: left; margin-bottom: 0px;">此外，個(gè)別參保人員隱瞞工傷、車禍等非醫(yī)保支付情形騙取醫(yī)保資金，甚至直接冒用他人醫(yī)保信息就醫(yī)報(bào)銷的情況亦不鮮見(jiàn)。我國(guó)社會(huì)保險(xiǎn)法明確規(guī)定，對(duì)于應(yīng)當(dāng)從工傷保險(xiǎn)基金支付或者由第三人、公共衛(wèi)生負(fù)擔(dān)及境外就醫(yī)情形下的醫(yī)療費(fèi)用，不納入基本醫(yī)?；鹬Ц斗秶z察辦案發(fā)現(xiàn)，個(gè)別參保人員虛構(gòu)、捏造或刻意隱瞞患病原因并就醫(yī)，騙取醫(yī)保基金報(bào)銷。</p><p style="text-indent: 2em; text-align: left; margin-bottom: 0px;">檢察機(jī)關(guān)提醒，醫(yī)?；鹗侨嗣袢罕姷摹熬让X”，決不能成為少數(shù)不法分子的“唐僧肉”。廣大群眾在依法享受醫(yī)療保障待遇的同時(shí)，要進(jìn)一步增強(qiáng)法治觀念、提高思想警惕，避免被不法分子利用。一旦發(fā)現(xiàn)欺詐騙保情況線索，要及時(shí)向有關(guān)部門反映，共同維護(hù)醫(yī)保基金持續(xù)健康發(fā)展，筑牢醫(yī)保基金安全防線。</p> </div> <p class="text-name">編輯：杜洋</p>  </div> </div> </div> <link rel="stylesheet" type="text/css" href="http://www.shangrongsuo.com/style/css/1200footer20240726.css" />  <div id="8b2xws4kyi" class="link wrapper_1200 clearfix"> <span>友情鏈接</span> <ul> <li> <a target="_blank">中國(guó)人大網(wǎng)</a> <a target="_blank">中國(guó)政府網(wǎng)</a> <a target="_blank">中國(guó)長(zhǎng)安網(wǎng)</a> <a target="_blank">司法部網(wǎng)站</a> <a target="_blank">中國(guó)網(wǎng)信網(wǎng)</a> <a target="_blank">中國(guó)記協(xié)網(wǎng)</a> <a target="_blank">人民網(wǎng)</a> <a target="_blank">新華網(wǎng)</a> <a target="_blank">央視網(wǎng)</a> <a target="_blank">央廣網(wǎng)</a> <a target="_blank">光明網(wǎng)</a> <a target="_blank">中國(guó)經(jīng)濟(jì)網(wǎng)</a> <a target="_blank">中國(guó)網(wǎng)</a> </li> 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