Yixintang's refund of tens of millions of medical insurance funds should only be a "leopard head"
2024-08-17
한어Русский языкEnglishFrançaisIndonesianSanskrit日本語DeutschPortuguêsΕλληνικάespañolItalianoSuomalainenLatina
Let the supervision go from “checking once” to “checking all the time”, and truly ensure that any evil intentions to tamper with the medical insurance funds will not escape the “eagle eyes” of supervision.
The picture content comes from the Internet
Ding Tie, special commentator of Caiyun.com
When writing an article, we should pay attention to the details. When dealing with matters concerning the vital interests of the people, we should also pay attention to the details. On August 16, the WeChat official account of the "National Medical Insurance Bureau" released the "Rectification Situation of Yixintang Pharmaceutical Group", pointing out that more than 10.7 million yuan of medical insurance funds related to violations had been returned. This is undoubtedly a "leopard head" for regulating medical insurance funds.
The medical insurance fund is a special fund used for basic medical insurance for employees. It is "life-saving money" that concerns the vital interests of the people. After the implementation of the outpatient coordination policy, more and more qualified medical insurance designated pharmacies have been included in the outpatient protection scope. This provides more convenience for insured persons, but at the same time, some pharmaceutical companies have also discovered the possibility of "taking advantage of loopholes". On May 24, 2024, the National Medical Insurance Administration interviewed Yixintang because some of its designated chain stores had problems such as substituting drugs, prescribing excessive amounts of drugs, conducting medical insurance settlements on behalf of designated retail stores that have suspended medical insurance settlements, mismatching drug purchase and sales records, and irregular sales of prescription drugs. To put it bluntly, it is to "open a loophole" in secret to make money from the medical insurance fund.
As a large pharmaceutical group with 9,179 directly-operated chain medical insurance designated pharmacies, Yixintang was summoned for rectification because some stores had problems such as substitution of drugs and over-prescribing of drugs, which caused losses to medical insurance funds. After self-examination and self-correction, the group has returned more than 10.7 million yuan of medical insurance funds involved in violations, and has taken a number of measures to strengthen internal management and standardize the use of medical insurance funds. The National Medical Insurance Administration's interview and rectification requirements for Yixintang this time reflect the strict supervision attitude towards the use of medical insurance funds. And through this incident, it should be seen that there are indeed deficiencies in the supervision of medical insurance funds. Therefore, although Yixintang has returned tens of millions of medical insurance funds, supervision cannot be called off. If supervision cannot be further improved, who can guarantee that "Erxintang" and "Sanxintang" will not emerge? Many times, killing a chicken cannot scare a monkey.
Through Yixintang, we can see the challenges facing the current management of medical insurance funds. Large chain drug stores may have violations such as replacing drugs and over-prescribing drugs during their operations. These behaviors not only damage the medical insurance funds, but also affect the rights and interests of patients. Having said that, large pharmaceutical companies are relatively easy to be exposed to supervision due to their large size and obvious goals. So, what about the scattered small drug stores and pharmacies? Has the tentacles of supervision reached them well? We cannot expect to knock all "tangs" with Yixintang, and it is difficult to guarantee that every pharmaceutical company will do business honestly in the case of incomplete and detailed supervision. Establishing a comprehensive supervision mechanism is obviously an important issue facing the medical insurance management department.
In addition to coverage, don’t forget the process issues. Yixintang was hit this time and was hurt, but there are countless cases of forgetting the pain after the wound healed. In other words, supervision cannot stop at checking and punishing, but must also "wait and see the results." After all, the fat piece of meat of medical insurance funds is too tempting. Unless we continue to strengthen the implementation of responsibilities and let supervision go from "a gust of wind" to "normalization", highlight technical empowerment, and let supervision go from "checking once" to "checking all the time", we can truly realize that any crooked thoughts about medical insurance funds will not escape the "eagle eyes" of supervision, and any violations will be punished when they are exposed, so as to ensure that medical insurance funds will no longer "leak".
Yixintang’s refund of tens of millions of medical insurance funds has opened the “leopard head” of medical insurance supervision. We are more looking forward to high-quality supervision with full coverage and the whole process writing the “pig belly”, so as to reap a wonderful “phoenix tail” in the near future.
All articles published on Caiyun.com only represent the personal opinions of the authors and have nothing to do with the position of this website. Welcome to follow Caiyun.com and send your articles to [email protected]. The payment will be generous.
