Pay attention to all insurance in the collection link.

1. Compare and analyze the detailed data of medical insurance with the detailed data of industry and commerce, taxation, endowment insurance and housing provident fund, and check whether there are uninsured or false payment base;

2. Compare and analyze the information of low-income households, rural five-guarantee households, urban "three noes", orphans and other personnel with the information of medical insurance participants, and check whether there are special groups who are not insured or insured without subsidies;

3. Extend the audit to investigate the payment of provincial and municipal management units and individual medical insurance funds, and check whether there are industrial enterprises or institutions that have not been included in the medical insurance management of local employees.

Pay attention to the safety of funds in management.

1. Review whether the collection agency or the employing unit falsely reports the number of insured persons, and take superior subsidy funds;

2. Focus on checking whether the handling personnel of the medical insurance agency have violated the rules to review and reimburse medical expenses or encroach on the medical insurance fund, and whether the relevant personnel have used the drug list for approval for personal gain and handling information system security issues.

Pay attention to the violations in the use of links.

1. Review whether the designated medical institutions have the phenomenon of patients hanging up the bed or being hospitalized as an impostor due to lax monitoring, whether there are irregular medical behaviors such as out-of-range prescription and over-examination, and whether there are illegal acts of defrauding medical insurance funds by fraudulent means;

2. Review whether there are problems such as inferior quality, high price and sales in designated retail pharmacies that damage the drug safety and interests of the insured. The third is to examine whether various medical insurance funds are extended to cover medical insurance expenses beyond the provisions.

The value-added link focuses on efficiency.

1. Check the interest income vouchers of medical insurance agencies and financial departments, check the interest receipts provided by banks with the interest rates announced by the People's Bank, and analyze whether preferential interest rates have been implemented;

2. Check the accuracy of the employee's personal account interest, and check whether there is a problem that the personal account does not bear interest or does not bear interest at preferential interest rates;

3. Check whether the handling agency has signed a written contract (agreement) with each commercial bank to implement the agreed deposit interest rate, and whether the interest is calculated according to the policy, so as to ensure the preservation and appreciation of the medical insurance fund.