Legal analysis: (1) 4,298 people in 19 cities and counties (excluding Sansha City and Yangpu, the same below) participated in the insurance repeatedly across regions or types of insurance. In 219, 4,298 people in 18 cities and counties participated in the insurance repeatedly across regions and types of insurance due to the lax review by the medical insurance authorities and agencies in various cities and counties. (2) The identity card information of 1,961 insured participants in 18 cities and counties is incorrect. Among the urban residents' medical insurance participants in 18 cities and counties in 219, 4,29 people had incorrect ID information; Among the participants of the new rural cooperative medical system in 219 in 16 cities and counties, 6,752 people have incorrect ID information. (3) The medical insurance for urban residents provided by various departments is inconsistent with the number of participants in the new rural cooperative medical system. The number of participants is the basis for correctly calculating the financial subsidies for medical insurance for urban and rural residents. Due to the different caliber of participants in relevant departments, the number of participants in the Provincial Taxation Bureau in 219 was 6,815,68 (including normal payers, special people and newborns); There are 6,837,361 people in the provincial medical security bureau and 6,845,354 people in the provincial social security service center. (4) Failing to pay the settlement amount of 427,22,1 yuan of designated medical institutions in time. By the end of 219, there were still 95,7 serious illness insurance premiums of 146,12,6 yuan in two insurance companies, namely Hainan Branch of Life Insurance and Hainan Branch of Ping An Pension, which were not paid to the designated medical institutions; The social security agencies in Danzhou City and Wanning City still owe RMB 281,95, to the settlement fees of 5 designated institutions in 219. (5) Failure to strengthen the supervision of medical service behavior, resulting in an overpayment of 2,831,3 yuan for employee medical insurance and the new rural cooperative medical system. In 219, 6 medical institutions in our province repeatedly charged 1,822,5 yuan for medical services such as intravenous injection, graded nursing and air conditioning cooling, resulting in 1,644, yuan for employee medical insurance and new rural cooperative medical system; 49 medical institutions repeatedly charged 2,588,9 yuan for medical consumables such as cotton balls, mousse stitches and disposable gloves, resulting in 1,187,3 yuan for employee medical insurance and new rural cooperative medical system. (VI) 2,38 people from disadvantaged groups in 17 cities and counties were not included in medical insurance. By the end of 219, 2,38 people with difficulties (including low-income people, poor people and people who set up files and set up cards) in 17 cities and counties were not included in urban residents' medical insurance, new rural cooperative medical insurance and serious illness insurance for urban and rural residents because the medical insurance authorities and agencies in various cities and counties did not seriously implement the medical insurance policies. (VII) 462 poor people who failed to return their files in time have paid the participation fee of the new rural cooperative medical system of 17,4 yuan. The management departments of the new rural cooperative medical system in Danzhou City and Wanning City failed to timely refund the participation fee of the new rural cooperative medical system from 218 to 219 of 17,4 yuan paid by 462 poverty-stricken people who set up their own files. (eight) the construction of the general drug code system of the provincial medical insurance information system and the centralized medical procurement service platform lags behind. By the end of 219, the medical insurance department of our province failed to promote the standardization of drug procurement code system in time according to the national requirements, resulting in that the drug information of each medical insurance information system could not correspond to the drugs purchased by the centralized medical procurement service platform, and it was difficult to realize the interconnection and sharing of information and data such as provincial centralized drug procurement platform, designated medical institutions, medical insurance agencies and price authorities.

legal basis: social insurance law of the people's Republic of China

article 2 the state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance to protect citizens' right to get material help from the state and society in case of old age, illness, industrial injury, unemployment and maternity.

article 26 the treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

article 28 medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.