In China, urban and rural medical insurance is mainly divided into three medical insurance systems: basic medical insurance for urban residents, basic medical insurance for urban workers and new rural cooperative medical care. NPC deputies suggested that? Social security fraud? It is very reasonable to write it into the criminal law, but how to effectively prevent fraudulent insurance has become a difficult problem. To prevent insurance fraud, we should start from the following aspects.
first of all. Increase the punishment for fraudulent insurance. It is not only a systematic problem but also a moral problem for the insured to take illegal and illegal actions, such as double insurance or intentional insurance fraud. The insured takes advantage of the defects of the current system, accepts speculative psychology, and tries to obtain more resources from the state with less investment. In essence, this will lead to unreasonable use and waste of medical resources and harm the interests of other insured. Therefore, we must improve the legal system, increase the punishment for insurance fraud, control it by administrative means, and increase the cost of illegal acts to curb insurance fraud.
Secondly, strengthen publicity and encourage residents to report. In order to improve the enthusiasm of the informed masses, the public security organs should cooperate with the medical insurance department to mobilize the masses from the following aspects: First, widely publicize the laws, regulations and policies on the supervision of medical insurance funds, so that the masses know what behaviors constitute social medical insurance fraud crimes, make them aware of the harmfulness of such crimes, and create a good public opinion environment for cracking down on medical insurance crimes. Broaden the channels of reporting clues and innovate the forms of reporting.
finally, use big data to analyze and catch insurance fraudsters. At present, China's medical insurance informatization has been gradually improved, and the wide application of big data and cloud computing technology provides a broad space for medical insurance data mining. Therefore, we should use technical means to extract relevant attributes and characteristics according to social medical insurance fraud, use data mining technology to identify and warn medical insurance fraud, establish an early warning model of medical insurance fraud, and improve vigilance. Find clues to the crime.