1 was blacklisted and punished jointly. For blacklisted units and individuals, cross-regional, cross-departmental and cross-disciplinary joint punishment shall be carried out in accordance with relevant state regulations.

2. The maximum penalty is five times. Insurance fraud is also fraud, and social insurance money needs to be returned. According to the seriousness of the case, a fine of more than two times and less than five times the amount of fraud is imposed.

3. If it constitutes a crime of fraud, it needs to bear criminal responsibility. Whoever defrauds pension, medical care, work injury, unemployment, maternity and other social insurance benefits or other social insurance benefits by fraud, forged certification materials or other means belongs to the act of defrauding public or private property as stipulated in Article 266 of the Criminal Law, but the defrauded insurance premium has been refunded, and may be given a lighter punishment or exempted from criminal punishment.

What are the typical fraudulent behaviors of designated medical institutions?

1, fabricating medical services, forging medical documents and bills, and defrauding medical security funds;

2. Providing false invoices for the insured;

3, will be borne by the individual medical expenses credited to the medical insurance fund payment range;

4. Enjoy medical insurance benefits for those who do not belong to medical insurance coverage;

5. Provide credit card bookkeeping services for non-designated medical institutions;

6. Nominal hospitalization;

7. Exchange drugs, consumables, articles, diagnosis and treatment projects, etc. Defrauding the medical insurance fund;

8 other fraudulent acts of designated medical institutions and their staff (excessive diagnosis and treatment, excessive medication, etc.). ).

In summary, the consequences of individuals defrauding medical insurance are listed in the "blacklist" and can be punished with a maximum fine of five times. If it touches the criminal law, it will be punished as fraud.

Legal basis:

Criminal law of the people's Republic of China

Article 266

Whoever defrauds public or private property in a relatively large amount shall be sentenced to fixed-term imprisonment of not more than three years, criminal detention or public surveillance, and shall also, or shall 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.

Criminal law of the people's Republic of China

Article 198

Whoever commits insurance fraud under any of the following circumstances, if the amount is relatively large, shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention, and shall also be fined not less than 10,000 yuan but not more than 100,000 yuan; If the amount is huge or there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than five years but not more than ten years, and shall also be fined not less than 20,000 yuan but not more than 200,000 yuan; 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, and shall also be fined not less than 20,000 yuan but not more than 200,000 yuan, or his property shall be confiscated:

(1) The applicant intentionally fabricates the subject matter of insurance to defraud the insurance money;

(2) The applicant, the insured or the beneficiary fabricates false reasons or exaggerates the loss of the insured accident to defraud the insurance money.

(3) The applicant, the insured or the beneficiary fabricates an insurance accident that has never happened to defraud the insurance money;

(4) The applicant or the insured intentionally causes an insurance accident that causes property losses and defrauds the insurance money;

(5) The applicant or beneficiary intentionally causes the death, disability or illness of the insured to defraud the insurance money.

Whoever commits the acts listed in Items 4 and 5 of the preceding paragraph, which constitutes other crimes, shall be punished in accordance with the provisions of combined punishment for several crimes.

If a unit commits the crime mentioned in the first paragraph, it shall be fined, and the directly responsible person in charge and other directly responsible personnel shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention; If the amount is huge or there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than five years but not more than ten years; 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.