Patient: I'll hang up the bed and get some medicine.
Doctor: You can't talk about this outside.
Patient: You can't talk outside.
As long as there is a social security card, whoever gets any disease and takes any medicine will have a physical examination. Can patients really order food?
Li Zegeng, member of the investigation team of the Party Committee of Anhui University of Traditional Chinese Medicine: It is necessary to find out what went wrong in management and system.
Are there any irregularities in medical care and personnel? Is the hospital defrauding the national medical insurance?
If there is a conspiracy to cheat medical insurance in the hospital, and it is between patients and doctors, how to proceed? We can develop a lot of rich imagination, but then we can listen to a video taken during an unannounced visit. Let's analyze it.
Doctor: You can't talk about this outside.
Patient: OK.
Doctor: You can't talk when you go out. It is illegal for you to talk about it. You know not to talk about it.
Q: Will there be any problems?
Doctor: I don't think so.
Q: Even over there, you can't see that we are looking for someone else to do it, can you?
Doctor: I can't say for sure. It's okay. You just have to do it.
You see, this is an old saying, knowing that there are tigers in the mountains, it is biased towards the tiger mountain. Don't tell anyone through the medical workers wearing white clothes on their backs. This is illegal. Knowing or doing it, what kind of situation is it? Today (65438+1October 19), an investigation team has been set up and stationed in the hospital. Let's find out.
10 days, two hospitals were reported by the media in succession, suspected of defrauding the medical insurance fund. 1. On June 9, 65438, Yan Chai Hospital in Huai 'an, Jiangsu Province, a little-known private hospital, was under investigation for "allegedly defrauding medical insurance funds". Just yesterday, another hospital was unannounced reported by the media and was suspected of defrauding the medical insurance fund.
Ms. Chen: I went directly to the hospital, and then he helped me to hang up the bed for hospitalization. I told the doctor that I didn't have time to come to the hospital, and then he said yes.
Patient: Prescribing some medicine is mainly.
Q: It is ok to prescribe medicine. I will prescribe any medicine I need.
This is an unannounced video reported yesterday. The video shows that this hospital is the third affiliated hospital of Anhui University of Traditional Chinese Medicine. By following Ms. Chen's filming, an unannounced visit found that some departments in this hospital can "hang up the bed", that is, patients have gone through the hospitalization procedures, although they have not been admitted to the ward for treatment, they are still paid by the national medical insurance fund, and there are a series of abnormal phenomena such as "as long as they have a social security card, they can prescribe medicine for their families". Once this unannounced video was published, it immediately attracted public attention.
At noon today, the Anhui Provincial Health and Family Planning Commission issued a circular through the official WeChat account, indicating that a joint investigation team composed of the Provincial Health and Family Planning Commission, the Provincial Administration of Traditional Chinese Medicine and the University of Traditional Chinese Medicine has been set up, and will be stationed in the hospital at 8: 00 this morning for investigation. Find out the facts as soon as possible, clarify the responsibilities, and say that it will be dealt with seriously according to the law.
Today (65438+1October 19), the Third Affiliated Hospital of Anhui University of Traditional Chinese Medicine registered, saw a doctor and took medicine, and the hospital operated as usual. Yang Yonghui, deputy secretary of the Party Committee of the Third Affiliated Hospital of Anhui University of Traditional Chinese Medicine, responded to the "bed hanging phenomenon" mentioned in the unannounced visit today.
Yang Yonghui, Deputy Secretary of the Party Committee of the Third Affiliated Hospital of Anhui University of Traditional Chinese Medicine: It is definitely not true. I'm really in the hospital. According to the instructions of our hospital, all the procedures of his hospitalization and hospitalization are true. Only during his hospitalization, he did not strictly follow the management of hospitalization. Sometimes he comes back when he is not in the hospital.
Q: For example, why did the above people have such an interview recording when they checked?
Yang Yonghui: This should be theirs. We are in the process of investigation.
Are there any irregularities in the Third Affiliated Hospital of Anhui University of Traditional Chinese Medicine, relevant departments and medical staff? Is there any act of defrauding the medical insurance fund? The public still needs to wait for the results of the investigation.
Li Zegeng, member of the joint investigation team of the Party Committee of Anhui University of Traditional Chinese Medicine: We have to manage this piece again and must sort it out within the system. What's the matter? From the perspective of the school, we will never be partial to these issues. We must deal with who is the problem, what kind of problem, and what kind of problem we must deal with.
A joint investigation team composed of the Provincial Health Planning Commission, the Provincial Administration of Traditional Chinese Medicine and the University of Traditional Chinese Medicine should be set up, but it is still fast enough. I entered the hospital at 8 o'clock this morning to check the relevant truth. It is said that it will be announced after the investigation.
Bai: Look at charities. In fact, it is the state and each of our insured people who donate money behind their backs. Next, we continue to connect with Gu of the Health Development Research Center of the National Health Planning Commission. You see, Mr. Gu, when the National Audit Office checked the relevant medical insurance funds, it also found such a serious problem as "fraudulent insurance". Then everyone may be concerned about this problem. How to solve it completely? Is it too light now? Should we pay more attention to "fraudulent insurance" and increase penalties?
Gu: Well, we are in the Social Insurance Law, and its provisions stipulate that we should postpone these illegal expenses first. In addition, a penalty of more than two times and less than five times is one. In addition, the medical insurance management department can stop the qualification of designated medical institutions in hospitals. In the era of comprehensive medical insurance, it is actually difficult for hospitals to survive if this qualification is stopped. Another particularly serious case, such as the excessive medical treatment I mentioned just now. If the circumstances are serious, for example, it is not a simple decomposition of hospitalization, and the outpatient service is transferred to hospitalization.
Bai: Still overtreatment.
Gu: As previously exposed, it involves forging medical documents and fabricating some nonexistent medical behaviors to defraud funds.
Bai: This is not just a moral issue.
Gu: Yes, false invoices and similar problems should be dealt with through the relevant provisions of the criminal law.
Bai: Do you think all the existing penalty clauses actually exist? Does this mean that it should be strictly enforced and supervised in detail?
Yes, one aspect is the enforcement of the law. We can alleviate some problems by deepening the medical reform. Another is to give full play to multi-party supervision, and everyone is optimistic about their life-saving money together.
Bai: Thank you very much for your analysis. We really don't want this report to be true, but the investigation team must pass a rigorous and credible investigation and finally tell us that it is not true. If it is true, it may not be a bad thing, just as a new starting point.