Translation. Region: Russian Federation –
Source: People's Republic of China in Russian – People's Republic of China in Russian –
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Source: People's Republic of China – State Council News
BEIJING, April 1 (Xinhua) — China will take effect on April 1 with a series of guidelines aimed at strengthening the fight against fraud in the national basic medical insurance (BMI) system.
The document, which was reviewed and approved at a meeting of the National Medical Insurance Administration of China (NMA) in February this year, contains detailed provisions on the use, supervision and management of BMS funds, as well as legal liability.
According to the guidelines, cases of insurance fraud and abuse among designated medical and pharmaceutical institutions where the national BHI system has been implemented include actions such as inducing or persuading others to seek medical care or purchase drugs under fictitious names through persuasion, false advertising, illegal reduction or exemption from payment, or provision of additional material benefits or services.
For insured persons, if they, knowing about insurance fraud, nevertheless participate in events organized by others involving the use of health insurance funds and accept gifts, payment discounts, or additional services, they may be punished for fraud using health insurance funds.
The guidelines also state that the resale by an insured person of medications, medical supplies, or medical services that have already been paid for with funds from the BMS fund may be considered illegal resale.
Gu Rong, a spokesman for the GUMO, who is in charge of fund supervision and management, said at a press conference on Tuesday that the agency will launch pilot programs for credit history management in the health insurance sector, covering both designated medical and pharmaceutical institutions and insured individuals nationwide.
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