An inaugural meeting for the first batch of unannounced medical insurance fund inspections was conducted in Zhengzhou, Henan province, marking the commencement of a nationwide, cross-provincial initiative. The team is tasked with reviewing the utilization and management of medical insurance funds, along with the establishment and enforcement of pertinent internal control systems. The inspection period spans from January 1, 2022, to December 31, 2023, and encompasses four designated medical institutions and two chain pharmacies in Zhengzhou and Zhoukou.
Each province will have two cities inspected, including their capital cities, with a focus on public and private medical institutions, as well as designated pharmacies. The inspection will scrutinize a broad range of medical fields, with an emphasis on critical care medicine, anesthesia, and lung tumors, in addition to cardiovascular medicine, orthopedics, blood purification, rehabilitation, medical imaging, and clinical testing.
The primary objective is to investigate and penalize the misuse of medical insurance funds, fraud, and other illicit activities. For designated retail pharmacies, the inspection will concentrate on addressing fraudulent purchases, resale of medical insurance drugs, and drug swapping.
Additionally, a novel “retrospective” spot check mechanism will be implemented. Under this arrangement, healthcare security departments will randomly select five provinces for a “retrospective” assessment. The inspection teams will randomly pick one designated medical institution from each that has previously undergone national flying inspections in 2022 and prior years.- Flcube.com
