1. The crime of defrauding medical insurance will be treated as fraud. The interpretation of the criminal law stipulates that defrauding social insurance benefits such as pension, medical care, work injury, unemployment and maternity or other social insurance benefits by fraud, forged certification materials or other means belongs to the act of defrauding public and private property as stipulated in Article 266 of the Criminal Law.
2. Legal basis: Article 266 of the Criminal Law of People's Republic of China (PRC). If the amount of fraud is relatively large, he shall be sentenced to fixed-term imprisonment of not more than three years, criminal detention or public surveillance, and shall also or only be fined; If the amount is huge or there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than three years but not more than ten years and shall also be fined; If the amount is especially huge or there are other especially serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than 10 years or life imprisonment, and shall also be fined or confiscated. Where there are other provisions in this Law, such provisions shall prevail.
Second, the filing standards for defrauding medical insurance:
1. Those who defraud medical insurance, endowment insurance, work-related injury insurance, unemployment insurance and maternity insurance, the standard for filing a case for prosecution is more than 3,000 yuan 1 10,000 yuan.
2. According to Article 1 of the Interpretation on Several Issues Concerning the Specific Application of Laws in Handling Criminal Cases of Fraud, those who defraud public or private property in an amount of more than 3,000 yuan but less than 10,000 yuan, more than 30,000 yuan but less than 100,000 yuan and less than 500,000 yuan are respectively deemed as "large amount", "huge amount" and "extremely huge amount" as stipulated in Article 266 of the Criminal Law. The higher people's courts and people's procuratorates of all provinces, autonomous regions and municipalities directly under the Central Government may, in combination with the economic and social development of the region, jointly study and determine the specific amount standards implemented in the region within the scope of the amount specified in the preceding paragraph, and report them to the Supreme People's Court and the Supreme People's Procuratorate for the record.