Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology in Wuhan was heavily fined 57 million yuan for hospital insurance fraud. The method of committing the crime was not clever, and it was even said to be simple and crude. The reason why it was discovered It was discovered because someone reported it and provided clues, and the relevant departments organized an inspection.
On April 20, the National Medical Insurance Bureau issued a briefing on a special unannounced inspection of the hospital, indicating that after receiving clues in March, the National Medical Insurance Bureau, in conjunction with the National Health Commission and the State Administration for Market Regulation, I learned that the Hubei Medical Insurance Bureau and the Wuhan Municipal Medical Insurance Bureau conducted a surprise inspection of the hospital and found major problems.
Only from January 2017 to September 2022, Tongji Hospital falsely reported high-value orthopedic medical consumables and exchanged high-value consumables, defrauding medical insurance of more than 23.34 million yuan. He violated the "Social Insurance Law of the People's Republic of China" and the "Regulations on the Supervision and Administration of the Use of Medical Security Funds", and the Wuhan Municipal Medical Insurance Bureau punished him.
First of all, the hospital took the initiative to return more than 19.15 million yuan of medical insurance funds discovered by the hospital's self-examination, and imposed a fine of twice as much. The inspection revealed that the fraudulent amount of more than 4.18 million yuan was refunded and a fine of 5 times was imposed. . Then the use of the medical insurance fund for the orthopedics department of the hospital was suspended for 8 months. In addition, it was also discovered that the hospital's medical insurance amount of approximately 91.07 million yuan in 2021 was also suspected of illegal use, and is still being verified.
Tongji Hospital is a large comprehensive tertiary-level hospital with a reputation across the country. After Tongji was exposed to this insurance fraud, everyone was shocked. Because this can be Tongji, such a large hospital, and such a problem actually occurs, then other hospitals will have similar problems. A consumable worth 200 yuan was given to a patient, but the price on the bill was written at 600 yuan, making the patient mistakenly believe that the material he was using was of good quality.
The hospital was originally a place to save lives and heal the wounded, not a place to make money. Now that the relationship between doctors and patients is already tense, but such a problem has emerged, it has undoubtedly added a lot to the public's trust in the hospital. A rift. We hope that relevant state departments will strictly investigate major hospitals and not allow medical insurance to become a fund that benefits certain medical institutions. We also hope that the state will strictly investigate the opaque payment systems of hospitals.