Fines for defrauding medical insurance. If the insured fraudulently uses other people's medical insurance vouchers to seek medical treatment or purchase medicines, or defrauds medical insurance fund expenditures by forging, altering, concealing, tampering, destroying medical documents, medical certificates, accounting vouchers, electronic information and other related materials or fictitious medical service items, the online settlement of medical expenses will be suspended for 3 months to 12 months, and the medical insurance administrative department will impose a fine of 2 to 5 times the amount defrauded.
If the insured person is suspected of defrauding the medical insurance fund and refuses to cooperate with the investigation, the administrative department of medical insurance may request the medical insurance agency to suspend the online settlement of medical expenses. The medical expenses incurred during the suspension of online settlement shall be paid in full by the insured. Designated medical institutions cheat medical insurance fund expenditures by inducing and assisting others to seek medical treatment falsely, buying medicines, providing false certification materials, or colluding with others to falsely issue expense documents, and the medical insurance administrative department shall order them to return, and impose a fine of 2 to 5 times the amount defrauded.
Some family members have a high reimbursement rate. In order to save money, the whole family uses his medical insurance card to see a doctor and take medicine. When the regulations are promulgated, there are laws to follow. On the one hand, it blocked 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 supervise, and most people dare not take risks to cheat insurance. The fine of 2 to 5 times the amount of fraudulent insurance is the amount spent by the relevant state departments after big data screening on the normal use of residents' medical insurance cards every year. It is formulated according to China's current national economic situation and conforms to the actual national conditions at this stage.
The Regulations on the Supervision and Administration of the Use of Medical Insurance Funds clearly stipulates that those who defraud medical insurance funds shall be ordered by the administrative department of medical insurance to return them and be fined 2 to 5 times the amount defrauded. The consequences of insurance fraud can be big or small, and the consequences of being refused compensation and extortion by the insurance company are very small. Not only will it face administrative punishment, but it may also evolve into a more serious fraud crime in legal practice and be investigated by law.