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strict investigation of excessive "glycosylated hemoglobin testing" led to the recovery of nearly 60 million yuan in medical insurance

2024-09-10

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the state council information office held a series of press conferences on "promoting high-quality development" today (10th). relevant officials introduced that in order to protect the "money bag" of medical insurance, this year the national medical insurance administration insisted on strict investigation and crackdown, continued to increase the intensity of flight inspections, and played the role of big data, investigating and handling a number of fraud and insurance fraud cases such as "glycosylated hemoglobin testing" and "female patients undergoing men's medical treatment".

yan qinghui, deputy director of the national healthcare security administration:since the beginning of this year, the national health insurance administration has focused on three aspects of work:

first, we will continue to crack down on and investigate strictly. we will continue to increase the intensity of unannounced inspections. so far, we have inspected 432 designated medical institutions in 30 provinces. it is expected that the number of institutions inspected this year will exceed the total of the past five years, and the scope of inspection will be relatively large.

local governments have stepped up their crackdown efforts, and a number of institutions suspected of fraud and insurance fraud have been terminated and transferred to the public security bureau.

compared with previous years, this year more emphasis is placed on the role of big data. through the "glycated hemoglobin" screening clues, nearly 60 million yuan of medical insurance funds have been verified and recovered, and through the "gender-restricted diagnosis, examination, and medication" screening clues, nearly 14 million yuan of medical insurance funds have been recovered, achieving "precision strikes" through the combination of on-site inspections and big data.