□ Correspondent Zhao Yun Reporter Shang Shuli
Company executives lied about pregnant women's information.
Defrauding maternity allowance and other expenses of more than 4 million yuan.
Hangzhou yi traditional Chinese medicine out-patient department
Suspected of "stealing" nearly 500 student medical insurance cards
On February 20 15, 15, Hangzhou Public Security Bureau received an alarm from a college student, saying that his mobile phone with medical insurance account has been receiving medical insurance credit card records recently.
This tip-off clue has attracted the attention of the public security department. Because college students in Hangzhou don't have citizen cards, they only have a medical insurance account. Usually, when you go to the hospital to see a doctor, you only need to report your account, so once the account information is leaked, it is likely to be "stolen" by criminals.
Through the investigation and analysis of a large amount of information, investigators found that a Chinese medicine clinic named Chuyuetang was suspected of committing a major crime. Because there are a large number of student medical insurance card swiping records here every day, there are more than 30 swiping records in an hour at most.
On the premise of conclusive evidence, the police arrested the operators, operators and managers of Chuyuetang according to law.
Gu, the captain of the Second Criminal Investigation Brigade of Hangzhou Public Security Bureau, told the reporter that the case involved more than 490 students from seven universities. Because the case of Chuyuetang is more complicated, in addition to students, it also involves a large number of social workers whose medical insurance cards have been stolen, so the case is still being detected.
"In recent years, it has been repeatedly prohibited to defraud social security and medical insurance funds by changing medicines, forging fake prescriptions, and forging' terminally ill' medical records for early retirement." The staff of Hangzhou Procuratorate introduced.
Zhao Zuguo, member of the party group and deputy director of Hangzhou Human Resources and Social Security Bureau, also said that the means of criminals defrauding social security funds are increasingly hidden, the means are constantly being refurbished, the amount involved remains high, and even new situations have emerged in which the insured colludes with relevant institutions to defraud insurance money.
Chen Jing is an executive of a company in Hangzhou. Since 2009, Chen Jing has used his position in company management to fabricate and falsely report the employment information of XXX and other 12 pregnant female employees. By paying a small amount of social insurance premiums, stopping payment after receiving maternity insurance benefits, etc., they have successively declared fraudulent maternity allowance and maternity medical expenses totaling more than 300,000 yuan, and paid them to other companies by applying for transfer.
After tasting the sweetness, from April of 20 10, three other companies were registered and established in the name of their mother Zhang Moumou. Before the company actually hired 14 1 pregnant women, they obtained their information from others. Similarly, she defrauded maternity allowance and maternity medical expenses of more than 3.9 million yuan through the above means, and claimed to reimburse maternity expenses.
Last year, in June 5438+10, the court sentenced the defendant Chen Jing to fixed-term imprisonment 14 years for fraud.
Relatives mixed medical insurance card
If the amount exceeds 6000 yuan, it constitutes fraud.
There are "inner ghosts" in the human society department.
Six social security workers were investigated for criminal responsibility.
As we all know, the declaration and approval of social security and medical insurance benefits need to go through many procedures, but why some people can successfully pass the checkpoint and successfully defraud social security funds for a long time has aroused the deep thinking of the procuratorate.
While stepping up efforts to crack down on criminal cases of insurance fraud, Hangzhou procuratorial organs pay attention to digging deep into the duty crimes behind criminal cases of insurance fraud, resolutely investigate and deal with crimes of corruption, bribery, abuse of power and dereliction of duty committed by individual staff in human and social departments, cut off the interest transmission chain, and eradicate the source of insurance fraud crimes. Six social security workers were investigated for criminal responsibility.
The cases of abuse of power and bribery of Yong Zheng and Chu Yun, staff members of Lin 'an Municipal People's Social Security Bureau, examined and prosecuted by Lin 'an Procuratorate are typical cases.
Yongzheng was originally the director of the Social Security Department of Lin 'an Human Resources and Social Security Bureau. From 2008 to 20 13, Yongzheng worked alone or with his wife, defendant Chu Yun, in the unemployment insurance department of Lin 'an Employment Management Service Office. Taking advantage of his position in handling retirement procedures, he colluded with the defendants Chen Yaping and Ni Peiqiang (handled separately) in advance. The above-mentioned personnel provided false hospital cancer medical records, pathological reports and other application materials, and handled fake retirement procedures for 58 people who did not meet the conditions for early retirement due to illness, resulting in a direct loss of more than 3.5 million yuan from the National Social Security Fund, and Yongzheng alone or together with Chu Yun received more than 500,000 yuan in benefits.
After examination and prosecution by the procuratorate, the court sentenced the defendants Yongzheng and Chu Yun to 6 years and 8 years respectively for accepting bribes and abusing their power. The defendants Chen Yaping and Ni Peiqiang were sentenced to 16 years and 14 years for accepting bribes and fraud respectively. Recovered economic losses of more than 3.6 million yuan for the country.
"This kind of insurance fraud cases usually involve a large number of people, a large amount and a great social impact. These "moths" ignore laws and responsibilities, take advantage of their positions to guard against theft and harm the vital rights and interests of the people. The procuratorate will never tolerate this. " Gu, Party Secretary and Procurator-General of Hangzhou Procuratorate, said.
At the end of 20 14, Hangzhou Procuratorate took the initiative to establish a new linkage mechanism with Hangzhou Public Security Bureau, Hangzhou Municipal Bureau of Human Resources and Social Security and other units to crack down on defrauding social security funds.
Since the operation of this mechanism, the human resources and social security department of Hangzhou has conducted a dragnet investigation on more than 2 100 designated medical insurance institutions in the city. At present, 43 case clues have been transferred to the public security organs, which is more than twice the total number of clues transferred in the previous three years.
Among them, the public security organs in Hangzhou filed 29 cases for investigation, and the procuratorial organs filed 2 cases for investigation of duty crimes in this field. After examination and prosecution, 78 people have been sentenced, involving a total amount of130,000 yuan, saving the country more than 6.3 million yuan.
20 15 Zhejiang provincial procuratorate issued a special document to promote this mechanism to the procuratorial organs of the whole province.
The reporter learned that whether relatives mix medical insurance cards or steal medical insurance cards, as long as the amount reaches more than 6,000 yuan, it constitutes a crime of fraud and reaches the threshold of imprisonment.
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