South bureau of safeguard of medical treatment of country of dispatch reporter Wu Bin was released on April 11 " fund of medical treatment safeguard uses superintendency byelaw (ask for an opinion to stalk of grain) " . Should ask for opinion draft to plan to set, once check solid cause medical treatment to ensure fund losing condition, can be in the at least double amerce of loss amount.
It is reported, the place in asking for an opinion to stalk of grain says fund of medical treatment safeguard includes: The worker is basic medical treatment insurance, dweller is basic the special fund such as deliverance of medical treatment insurance, birth insurance, medical treatment. In addition, a serious illness nurses safely, for a long time the supervisory management of insurance and capital of safeguard of other medical treatment, according to rules will carry out.
Protect the superintendency of fund to strengthen pair of cure, ask for opinion draft to plan to make clear, bureau of safeguard of medical treatment of the State Council builds a flight to check working mechanism. National medical service is protected the bureau is responsible the flight examination inside limits of constituent executive whole nation. Provincial cure is protected bureau carry out the flight inside respective province to check.
Seek the regulation in opinion draft, cure protects fund to superintend an object to include: The medical orgnaization that cure guarantees agency orgnaization, calm place (the hospital that decide a dot and retail drugstore) , the doctor apothecary of consultative government and individual.
The person that individual ginseng is protected or the object of medical treatment deliverance also is one of superintendency objects. When their use medical treatment safeguard fund sees a doctor, when buying drug, ought to hold him medical treatment to ensure significant evidence to see a doctor, buy drug and show actively receive probate probate, must not ensure him medical treatment significant evidence to rent (borrow) to other; Must not forge; Must not forge falsification to prove material diddle medical treatment ensures fund.
Notable is, ask for an opinion to stalk of grain to list one emphasizes technically, any units and individual do not get another person of organization, abet, lure by promise of gain, threatening, help con diddle medical treatment ensures fund.
South the reporter notices, in asking for an opinion to stalk of grain, appear " expenses of fund of safeguard of medical treatment of diddle of organization, abet other, cause abominable society effect " circumstance, belong to " the clue is particularly serious " one of circumstances, cause cure to keep fund loss, besides return fund, still can be in fivefold amerce.
According to seeking an opinion draft sets, cure protects a branch to violate compasses condition according to breaking the law, the condemnatory step that can make has 6 kinds: Warning, confiscate illegal earning and duple above fines place illegal amount below fivefold, instruct agency orgnaization break down or remove cure (medicine) division service qualification, instruct agency orgnaization break down or remove cure defends a service agreement, bring into break one's promise list of associated chasten object, move send concerned service.
This is meant, defend the case of fund to diddle cure, once appear,cure keeps fund loss, double the amerce amount award that cure defends a department is illegal amount at least.
For instance, ask for the citing in opinion draft, "Medical service action is real exist, but declare project, amount and real service action not conform to, the difference is not big " , this belongs to a clue slight. To this kind of circumstance, cure protects a branch to be able to give caution talk about, cause cure to protect fund losing, besides instruct go back debt, can handle illegal number 2 times amerce.
Besides 2 times amerce, ask for an opinion to stalked of grain to still set 3 times amerce, 4 times amerce and the specific condition of 5 times amerce, part corresponding " the clue is heavier " , " the clue is serious " , " the clue is particularly serious " circumstance.
Be worth what carry is, ask for opinion draft special train a regulation, ginseng protect personnel and boy or girl friend of medical treatment minister to ensure him medical treatment significant evidence to rent (borrow) give another person or nod medical treatment of medical orgnaization diddle to ensure fund surely, by medical treatment safeguard service recovers medical treatment to ensure fund, suspend pay of settle accounts of its couplet net exceeding 12 months, inspect a clue serious degree is in duple above to fine below fivefold.
In addition, still one plans to set, join those who protect personnel and boy or girl friend of medical treatment minister to forge falsification bill, prescription, anamnesis to wait for medical treatment of proof material diddle to ensure fund, by medical treatment safeguard service recovers medical treatment to ensure fund, suspend pay of settle accounts of its couplet net exceeding 12 months, be in illegal amount to fine fivefold, be suspected of crime, investigate criminal duty lawfully.
