14 types of behaviors of designated medical service institutions, designated drug business units, insured individuals and other people are fraudulent and deceitful acts of the medical insurance fund.
2 Allowing or inducing a non-participating individual to be hospitalized in the name of the participant.
3 Declaring medical expenses that should be paid by the insured individual out-of-pocket or at his own expense to be paid by the medical insurance fund.
4 hospitalization or hospitalization of an insured individual who can be treated on an outpatient basis.
5Transitional medical treatment or provision of unnecessary medical services by means of duplicate registration, duplicate or non-indicated treatment, or decomposition of hospitalization for insured individuals.
6 Violating the regulations on the scope of medication or the variety of medication used for medical insurance, dispensing medication to insured individuals by overdosing, duplicating medication, using medication with special restrictions in violation of the regulations, or dispensing medication to insured individuals by breaking down or changing prescriptions.
7 Combining the expenses incurred by non-designated medical institutions into the expenses of designated medical institutions for settlement with the medical insurance agency.
8Assisting an insured individual to withdraw funds from the individual account or the integrated fund of medical insurance.
9 unauthorized increase in fees, increase in fees, decomposition of fees, duplication of fees, expansion of the scope of fees and other irregularities in charging.
10Falsification, by misrepresentation, false transmission of data and other ways to seize the medical insurance fund or individual account fund.
11Selling medicines for non-designated drug business units and swiping social security cards on their behalf.
12Switching medicines, diagnostic and therapeutic items, medical materials, medical service facilities or daily necessities, health care supplements and other expenses outside the scope of payment of medical insurance to expenses within the scope of medical insurance policy, applying for medical insurance settlement, and cashing in on the fund payment.
13Forgery or use of false medical records, prescriptions, inspection and laboratory reports, diagnosis of disease and other medical documents to fraudulently obtain medical insurance funds.
14 The use of false medical bills for reimbursement.
15Other violations of the relevant provisions of social insurance, resulting in losses to the medical insurance fund.
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