According to the Labor Security Supervision Regulations and the Administrative Punishment Law:

First, recover the defrauded medical insurance pooling fund according to law;

Two, impose a fine of twice the amount of fraud on designated hospitals;

Three, ordered the hospital to conduct a written examination, in accordance with the relevant provisions of medical insurance for a period of three months of rectification, the rectification period shall not be admitted to the insured patients. If the rectification period still fails to meet the requirements, the qualification of the designated medical institution for medical insurance in this hospital shall be cancelled according to the regulations.

The medical insurance fund refers to the special funds for basic medical insurance for employees raised by medical insurance agencies from units and individuals to ensure basic medical care for employees. The basic medical insurance fund includes two parts: social pooling fund and individual account, which are paid by employers and individual employees according to a certain proportion.

Medical insurance belongs to the business scope of labor security. The basic medical insurance premiums paid by the insured individuals are all included in the personal account; The basic medical insurance premium paid by the insured unit, except for the part credited to the personal account, is all used as a unified fund, which is managed and used uniformly by the medical insurance agency. Personal accounts are mainly used to pay for outpatient and drug purchase expenses, and the overall fund is mainly used to pay for medical expenses of insured persons for hospitalization, outpatient specific projects and some chronic diseases and family beds. The serious illness medical assistance fund is used to pay the hospitalization medical expenses above the maximum payment limit of the basic medical insurance pooling fund of the insured.

At present, the financing mode of the basic medical insurance system for urban workers in China is the combination of social pooling and individual accounts, that is, employers and employees pay basic medical insurance premiums according to a certain proportion of total wages, forming social medical pooling funds and individual medical account funds.