Tongji hospital is shoddy. For example, 200 yuan, a steel plate implanted in the body, was written as 600 yuan in the hospital, which resulted in more patients' burden and more medical insurance fund losses. In addition to ordering tongji hospital to rectify, the hospital was fined twice for self-examination and voluntarily returning the defrauded medical insurance fund amount, and fined five times for the defrauded fund amount found in the inspection, totaling more than 59 million yuan. In addition, tongji hospital was ordered to suspend the use of medical services involved in the medical insurance fund for 8 months; According to the law and regulations, the case clues will be transferred to public security, market supervision, drug supervision, health and health, discipline inspection and supervision and other relevant departments.
In addition, the hospital said that it will strictly follow the requirements of the National Medical Insurance Bureau and the provincial and municipal medical insurance bureaus, compact the main responsibility, comprehensively and thoroughly rectify, strengthen the accountability mechanism, seriously deal with those involved, and resolutely put an end to similar incidents. An orthopedic surgeon who did not want to be named told the Health Times reporter that the exchange of medical consumables refers to the exchange and reimbursement of medical consumables and other non-catalog items that are not covered by the medical insurance fund, or the settlement of low-standard charging items as high-standard charging items.
Because of the variety and high price of orthopedic consumables, it is the hardest hit area of medical corruption. Cheat insurance by changing or falsely reporting high-value orthopedic medical consumables. This kind of series charging, repeated charging and false charging is a typical insurance fraud. The hospital recorded the unconsumed consumables as being used in the financial system to defraud the medical insurance fund.