Fraud will be fined up to 5 times the amount of medical insurance, how to define whether it is insur

Once the act of defrauding medical insurance is hammered, a fine of up to 5 times will be imposed, how to define this kind of insurance fraud? In fact, it is very simple, it is to see if there is a problem with the material you provideMoreover, after discovering that there are corresponding problems with the materials, you can verify them on the spot, and as long as you verify them, you will be able to confirm whether they are true or false. <>

Fraudulent medical insurance, which means that if I am now within the scope of the medical insurance system, my name is Zhang San, and then I know a doctor, we have a very good relationship, I can pretend to be hospitalized through such a relationship as a doctor, I am actually not sick and healthy, and I am still doing my job normally, but nominally I was hospitalized, lived for 10 days, and then I spent 10,000 yuan, because of the relationship with the doctor, he used me in this medical record, this drug and so onMeYou can take this material to reimburse, and I can get about 6,000 yuan according to the actual proportion of 60%. <>

But this 6,000 yuan definitely doesn't belong to me, because the doctor also took a lot of risk for this, and he must divide a part of it to the doctor, and then the two of us did it once and found that it was very good, and the risk was not high, what risk he could take, that is, to show me this case, as long as I reviewed the follow-up, there was no problem, and then we reached a long-term cooperation to drive the people around us to realize the dream of making a fortune, but this kind of behavior is insurance fraud, Because you weren't hospitalized at all, you didn't spend that money at allYou just want the reimbursement money for medical insurance, there have been many such situations before, and it was strictly investigated in the first two years, and now it is much better. <>

In fact, as long as you drink tea on the spot, you will know, because there must be a problem with the submission of the material, and the professionals will know at a glance what the medicine you use for this disease is, if you are actually hospitalized, your society involves a lot of scattered expenditures involving a lot of drugs, what is your disease, what is the disease, what is the disease, there is no medicine, some drug dosages are obviously exceeded, and there are some obvious drug doses that are indeed missing some key points to this is a problem, after finding the problem,Go to this hospital on the spot to check whether there is really this person in the hospitalization record, and whether there is a corresponding video of hospitalization in the hospital, and it will be clear at once.

It is for the purpose of illegal possession, using fictitious facts or concealing the truth to defraud the insurance money, if the amount is large enough, it may constitute the crime of insurance fraud.

The main mode of behavior is manifested in the fact that the policyholder fabricates the subject matter of the insurance, and the policyholder, the insured, and the beneficiary fabricate false reasons for the occurrence of the insurance accident, or exaggerate the extent of the loss, and defraud the insurance money.

If it does not correspond to the actual situation, and there are some human operations, then it is this kind of behavior.

The expenses of the policyholder who should be reimbursed for medical treatment cannot be reimbursed, and some people who are not sick and should not be reimbursed deceives the medical insurance!

Personally, I think that if you want to identify the behavior of insurance fraud, at this time, you just need to check whether you are really sick and hospitalized, and whether you are really being treated?

Fraud of medical insurance funds, once this behavior is confirmed, a maximum of 5 times the fine will be issued, that is to say, you will be fined 5000 yuan if you defraud 1000 yuan, and the corresponding administrative punishment is serious The lead organization may also bear criminal responsibilityIt is because of these protections of medical insurance that most ordinary people can have the last barrier of risk resistance in the face of serious illness. <>

We are usually sick and hospitalized as long as you have medical insurance can basically reimburse you 60% 80%, this is most common diseases are no problem, you spend 10,000 yuan, and you may eventually be able to reimburse you about 7,000 yuan, the rest of the money is your own spending, you go to medical insurance every year about 200 yuan to 300 yuan, so you are hospitalized to reimburse this money is your own money, but young people pay two or three hundred yuan a year for this medical insurance, But in fact, you don't need this thing, because you don't need to be hospitalized when you're young, but you will be able to use it in the future, so part of the funds in the medical insurance pool are paid by the user himself, which is the two or three hundred yuan you pay every yearThen there is a part of the ** national policy subsidy, but in any case this total is fixed. <>

Since this total is fixed, it is necessary to use the money on the blade, that is, to use it for the diseases that most ordinary people need, such as common hard injuries, broken bones, or gastrointestinal diseases or high blood pressure, hyperlipidemia, high blood sugar, diabetes, these are common chronic diseases, most people may encounter them, then these are within the scope of the guarantee, this is the meaning of the existence of medical insurance, but if someone cheats the insurance, he is not sick, he wants the reimbursement money，Some internal ghosts should be combined with the outside, which affects the fairness of the medical insurance fund pool and fund allocation. <>

Because the funds in this are limited, after being deceived by some people, and finally some people can't get more money, although there is a national financial guarantee, so that everyone can basically be reimbursed, but this kind of insurance fraud is still very bad, that is, it is not sick, he has to make this cheap, this kind of behavior appeared a few years ago, and even had a big impact at that timeIn the past two years, the regulations have become more and more stringent, and once the new regulations are confirmed, they may withdraw 5 times the fine.

Personally, I think that defrauding medical insurance funds will definitely be punished very much, after all, this kind of behavior is already suspected of fraud, and it is likely to require jail time.

It may be affected by the sentencing, because defrauding medical insurance is also a fraud, and our country has zero tolerance for fraud, so don't know the law.

Criminal penalties. Disrupting the normal order of medical insurance work meets the constitutive elements of the crime of contract fraud, constitutes the crime of contract fraud, and should be subject to criminal punishment.

I don't think a five-fold fine is too much, it's very reasonable.

The amount of fines for defrauding medical insurance funds insured persons fraudulently use other people's medical insurance vouchers for medical treatment and drug purchases, or forge, alter, conceal, tamper with, destroy medical documents, medical certificates, accounting vouchers, electronic information and other relevant information or fictitious medical service items to defraud medical insurance ** expenditure, suspend the online settlement of medical expenses for 3 months to 12 months, and at the same time imposed a fine of 2 times to 5 times the amount of fraud by the medical insurance administrative department.

If the insured is suspected of defrauding the medical insurance ** expenditure and refuses to cooperate with the investigation, the medical insurance administrative department may request the medical insurance agency to suspend the online settlement of medical expenses. Medical expenses incurred during the suspension of online settlement shall be paid in full by the insured. Designated medical institutions by inducing, assisting others to seek medical treatment in a false name, purchasing drugs, providing false supporting materials, or colluding with others to falsely issue expense documents to defraud medical insurance ** expenditure, by the medical insurance administrative department ordered to return, and imposed a fine of 2 times to 5 times the amount of fraud.

Some family members have a high reimbursement rate, and the whole family uses his medical insurance card to see a doctor and take medicine, with the intention of saving money. With the promulgation of the regulations, there are laws to follow. On the one hand, it plugged the loopholes in the hospital, and doctors did not dare to prescribe drugs without their own medical insurance cards.

Everyone knows that the state has begun to regulate, and most people dare not take the risk of cheating insurance. The fine of 2 to 5 times the amount of insurance fraud is the amount spent by the relevant state departments every year after big data screening of the normal medication of residents' medical insurance cards, which is formulated according to the current national economic situation of China and is in line with the actual national conditions at this stage.

The Regulations on the Supervision and Administration of the Use of Medical Insurance ** clearly stipulate that if the medical insurance is obtained by fraud, the medical insurance administrative department shall order it to be refunded and impose a fine of 2 times to 5 times the amount of fraud. The consequences of insurance fraud can be large or small, and the consequences of being refused compensation and extortion by insurance companies are very small, and they will not only face administrative penalties, but may also evolve into more serious fraud crimes in legal practice, and will be prosecuted by law.

Five times is no more, no less, just right, too little will not work, too much is a bit too much, but don't cheat the insurance, it's best to abide by the law.

Personally, I don't think a 5x fine is much. Because this is the only way to sound the alarm for those who also want to cheat health insurance money. So that such people can give up the idea of cheating on health insurance funds. Since you make a mistake, you will be punished.

I don't think a five-fold fine is a lot, because what you are committing is not so simple, you are violating the bottom line of the state system, and you are also trying to break the bottom line of the law.

Legal Analysis: Administrative Punishment: If a person fraudulently obtains social insurance benefits by fraud, falsification of supporting materials or other means, the social insurance administrative department shall order the return of the social insurance money obtained by fraud and impose a fine of 2 to 5 times the amount obtained by fraud.

Criminal punishment: If the amount of fraud is relatively large, the sentence shall be up to three years imprisonment, short-term detention or controlled release; where the amount involved is huge, a sentence of 3 to 10 years imprisonment and a concurrent fine may be imposed; where the amount is especially huge or there are other especially serious circumstances, a sentence of 10 or more years imprisonment or even life imprisonment may be given, and a concurrent fine or confiscation of property may be given.

Legal basis: "Criminal Law of the People's Republic of China" Article 266: Where public or private property is defrauded, and the amount is relatively large, a sentence of up to three years imprisonment, short-term detention, or controlled release is to be given, and/or a fine; where the amount is huge or there are other serious circumstances, a sentence of between 3 and 10 years imprisonment and a concurrent fine is to be given; where the amount is especially huge or there are other especially serious circumstances, a sentence of 10 or more years imprisonment or indefinite imprisonment is to be given, and a concurrent fine or confiscation of property. Where there are other provisions in this Law, follow those provisions.

Do you know? It is an offence to cheat on insurance, and a fine of between 2 and 5 times the amount obtained by fraud is imposed. Since May 1, China's first special law and regulation in the field of medical insurance, the "Regulations on the Supervision and Administration of the Use of Medical Security", has been implemented, and the safe and effective use of medical insurance has been legally guaranteed.

Is the money cheated by medical insurance coming from?

The money deceived by medical insurance is the money in the national medical insurance pool, and the money in the medical insurance pool is known to be the money paid by each of our insured personnel, so if someone else cheats the insurance, the money he cheats is the money that cheats you, which can be understood in this way. Are you still willing to do so in this situation? That's definitely unwilling, if you cheat yourself, what you cheat is your own money and the money of other insured people, which is a crime.

Who is involved in insurance fraud?

There are four groups involved in health insurance fraud, and each group is important. The first group is the insured person, and the most common way for the insured person to defraud is to lend the medical insurance card to others, and the second is to resell the medicine bought with the medical insurance card to the drug dealer in exchange for cash. The second group is medical institutions or hospitals, which are all united to defraud insurance.

The third group is pharmacies, and the main insurance fraud behavior of pharmacies is to steal other people's medical insurance cards to obtain benefits. The fourth category is the handling agencies of the medical insurance office and the social security bureau, which will handle medical insurance benefits in violation of regulations, and handle the special medical insurance treatment procedures for those who do not meet the conditions for insurance, which is also regarded as insurance fraud. <>

What is the impact of insurance fraud on individuals?

If you find insurance fraud, be sure to report it. Therefore, each and every one of us should form this awareness. Don't cheat the insurance, don't have a fluke mentality, and think that it's okay if you cheat.

But once discovered, your life may be over, because you are about to bear the hat of a criminal case in this life, which is not only restricted for you to handle things personally, but more importantly, for your children are also subject to various restrictions, I hope to receive everyone's attention. <>

I think this behavior is particularly excessive. This is to deceive the state to maliciously obtain medical insurance, and it must be punished after it is found out.

It is a very shameful behavior to defraud medical insurance funds, and it is a low-quality behavior with no lower limit. Medical insurance is for everyone to get protection for serious illnesses. Instead of letting people cheat, doing so will cause chaos in health insurance.

I think this kind of behavior is very shameful, so the relevant departments must punish this kind of behavior severely.

I think this kind of behavior is incorrect, it is illegal, and the criminals should be included in the blacklist of dishonesty.

Personally, I think this kind of behavior must be punished, after all, I think this kind of behavior of cheating on medical insurance is too hateful, and they must be severely punished.

It's too severe, and such a fine is also quite terrible. Therefore, this person is also very uncomfortable, and it is also a big blow to him.

I think this fine is very correct, because the act of defrauding health insurance is very shameful, immoral and illegal, and must be severely punished.