In order to strengthen the management of social insurance funds, standardize the supervision and inspection of social insurance, and maintain the safety of social insurance funds, these Provisions are formulated in accordance with the provisions of the Social Insurance Law of People's Republic of China (PRC), the Labor Contract Law of People's Republic of China (PRC) and other laws and regulations, combined with the actual situation in Chengdu. Article 2 (Scope of Application)

These Provisions shall apply to the supervision and investigation of defrauding social insurance funds within the administrative area of this Municipality. Article 3 (Division of Functions and Powers)

The municipal social insurance administrative department is responsible for the supervision and inspection of the city's social insurance funds, and is responsible for investigating and handling the organization, guidance and coordination of fraudulent social insurance funds; District (city) county social insurance administrative department is responsible for the supervision and inspection of social insurance funds within their respective administrative areas.

City and district (city) county social insurance agencies to assist the social insurance administrative departments to do a good job in the supervision and inspection of social insurance funds.

Health, food and drug supervision and management, civil affairs, population and family planning, public security, industry and commerce, medical management, finance, price, auditing and supervision departments. They shall, within the scope of their respective duties, assist the administrative department of social insurance to supervise and inspect the acts of units and individuals defrauding social insurance funds. Article 4 (Cheating Social Insurance Fund)

The following acts belong to the act of defrauding social insurance funds:

(a) fabricating labor relations or providing false proof materials to defraud the social insurance qualification;

(2) Concealing or fabricating medical history, forging, altering or illegally changing fictitious social insurance treatment conditions such as personal identity certificates and archival materials, and defrauding social insurance treatment qualifications;

(three) the conditions for enjoying social insurance benefits have changed or lost the qualification to enjoy social insurance benefits, and continue to enjoy social insurance benefits without truthfully telling the social insurance agency;

(4) Forging or fraudulently using other people's social insurance certificates or payment vouchers;

(5) Giving my social insurance certificate or payment voucher to others to defraud social insurance benefits;

(six) false column, false report, inflated social insurance service items and amount, defrauding social insurance fund expenditure;

(seven) fabricating labor relations or providing false certification materials or expert opinions to help others defraud social insurance qualifications or enjoy social insurance benefits;

(eight) other acts of defrauding social insurance funds. Article 5 (Investigation Measures)

The administrative department of social insurance has the right to take the following measures to investigate and deal with acts of defrauding social insurance funds:

(a) to enter the places related to the investigation and inspection according to law, and to ask the relevant personnel about the investigation and inspection;

(two) access to accounting vouchers, accounting books, accounting statements and other information related to the management of social insurance funds;

(three) require the units and individuals under investigation and inspection to provide documents and materials related to the investigation and inspection matters, and make explanations and explanations, and issue an investigation inquiry when necessary;

(4) Collecting relevant information and materials by means of audio recording, audio recording, video recording, photographing or copying;

(five) entrust social intermediary institutions to audit the investigation and inspection matters;

(six) other investigation and inspection measures taken according to law. Article 6 (Investigation Methods)

The staff of the administrative department of social insurance shall not be less than two when conducting investigation and inspection, and shall produce administrative law enforcement certificates and make investigation records.

If the staff of the social insurance administrative department has a direct interest with the unit or individual under investigation, they should withdraw. Article 7 (Administrative Handling)

According to the results of investigation and inspection, the administrative department of social insurance shall make a decision to order rectification or administrative punishment for defrauding social insurance funds according to law; Those suspected of committing a crime shall be handed over to judicial organs for handling according to law. Article 8 (Working Hours)

The administrative department of social insurance shall investigate and deal with the act of defrauding social insurance funds, and shall complete it within 60 days from the date of filing the case; If the case is complicated, it may be extended for thirty days with the approval of the person in charge of the social insurance administrative department.

The time for identification and examination to find out the facts is not included in the time limit for handling cases stipulated in the preceding paragraph. Article 9 (Handling Procedures of Handling Agencies)

The social insurance agency shall conduct social insurance audit according to law on the act of defrauding social insurance funds; Units and individuals that refuse to accept the audit or do not cooperate with the audit work shall promptly report to the administrative department of social insurance for handling according to law. According to the audit results, the social insurance agency may make a decision to suspend or stop paying social insurance benefits or related expenses, and be entrusted by the social insurance administrative department to order it to return the defrauded social insurance money; If administrative punishment should be given according to law, it shall be reported to the administrative department of social insurance to make a decision on administrative punishment according to law.

Violation of the service agreement between designated medical institutions and retail pharmacies shall be handled in accordance with the agreement.

If the illegal facts are not established according to law, the social insurance agency shall go through the formalities of reissue and supplement the social insurance benefits or related expenses within five working days. Article 10 (Rights Relief)

The administrative department of social insurance shall listen to the statements and arguments of the unit or individual before making a decision on administrative punishment for the act of defrauding the social insurance fund by the unit or individual; Where a hearing is required by laws and regulations, the unit or individual shall be informed of the right to request a hearing according to law; If a unit or individual requests a hearing, the administrative department of social insurance shall organize a hearing.

If a unit or individual refuses to accept the decision made by the social insurance agency to suspend or stop paying social insurance benefits or related expenses, it has the right to apply for review or administrative reconsideration, or bring an administrative lawsuit to the people's court.