1, legal pay according to labor, do not accept commercial commission. The lawful remuneration according to the law. It is strictly prohibited to take advantage of the practice of billing commission; it is strictly prohibited to use commercial purposes to unify the prescription; in addition to other medical institutions in the medical association where the hospital is located, as well as the designated retail pharmacies included in the "dual-channel" management of medical insurance, it is strictly prohibited to arrange for the patient to purchase medical supplies and other products in other designated places; it is strictly prohibited to sell goods or services to patients and seek personal gain from them; it is strictly prohibited to accept the sale of goods or services to patients and seek personal gain from them. It is also strictly prohibited to sell goods or services to patients and seek personal gain from them; it is also strictly prohibited to accept fees from Internet enterprises related to prescription and dispensing of medicines.
2. Strictly abide by the principle of good faith and do not participate in fraudulent insurance. We will reasonably use the medical insurance fund in accordance with the law, abide by the management of the medical insurance agreement, and inform the medical insurance patients whether the medical services provided are within the scope of payment stipulated by the medical insurance. It is strictly prohibited to induce or assist others to fraudulently or falsely seek medical treatment or purchase medicines, provide false certificates, or conspire with others to falsely bill expenses to fraudulently or arbitrarily obtain medical insurance funds.
3, based on the standardization of the practice of medicine, do not implement excessive diagnosis and treatment. Strictly implement the rules and regulations, in the diagnosis and treatment activities should be explained to the patient's condition, medical measures. It is strictly prohibited to simply increase the income of medical institutions or for personal gain for the purpose of excessive treatment and excessive examination, adding unnecessary risks and costs to the patient's burden.
4, comply with work procedures, do not accept donations in violation of the law. Accept donations in accordance with the law. It is strictly prohibited for the staff of medical institutions to accept donations and funding from stakeholders in their personal name, or in the name of the organization under false pretenses, and treat patients differently accordingly.
5, abide by the confidentiality guidelines, do not disclose patient privacy. Ensure the safety of patient information in the hospital. It is strictly prohibited to violate the collection, use, processing, transmission, disclosure, trading of personal data provided by patients within the healthcare organization, generated medical information.
6. Obey the needs of diagnosis and treatment, and do not profitably refer patients. The medical information is provided and medical resources are utilized objectively, fairly and reasonably according to the needs of the patients. Except for normal referrals within the medical association, it is strictly prohibited to introduce and guide patients to designated medical institutions through online or offline channels for the purpose of personal gain.
7. Maintaining the order of medical treatment without jeopardizing the fairness of medical treatment. Adhere to the principle of equality, *** build a fair medical environment. It is strictly prohibited to use the number of sources, beds, scarce drugs and supplies and other medical resources or inspection, surgery and other diagnostic and treatment arrangements to receive benefits, public enrichment.
8, *** build a harmonious relationship, do not accept the affected party "red packets". Abide by medical ethics, strict self-discipline. It is strictly prohibited to solicit or accept patients and their relatives and friends of gifts, gratuities, consumer cards and securities, equity, other financial products and other property; strictly prohibited to participate in its arrangement, organization or payment of fees for banquets or travel, fitness, entertainment and other activities arranged.
9, abide by the bottom line of interaction, do not accept corporate kickbacks. Compliance with the law, honest practice. It is strictly prohibited to accept drugs, medical equipment, medical devices, medical and sanitary materials and other medical products production, business enterprises or distribution personnel in any name, form of kickbacks; strictly prohibited to participate in its arrangement, organization or payment of fees for banquets or travel, fitness, entertainment and other activities.
II. Fraudulent insurance practices include the following:
(1) providing false invoices to insured persons;
(2) crediting medical expenses that should be borne by individuals to be paid by the medical insurance fund;
(3) applying for medical insurance treatments for persons who do not belong to the scope of medical insurance;
(4) providing card-crediting services to non-designated medical institutions;
(5) providing medical services to non-designated medical institutions;
(6) providing medical services for persons who do not belong to the scope of medical insurance; and organizations to provide card-crediting services.
Third, what are the legal consequences for insurance fraudsters
1. If the insured or beneficiary falsely claims that an insurance accident has occurred and makes a request to the insurer for compensation or payment of insurance premiums without the occurrence of an insurance accident, the insurer has the right to terminate the insurance contract and will not refund the premiums;
2. If the policyholder, insured or beneficiary intentionally Create an insurance accident, the insurer has the right to terminate the insurance contract, and does not assume the responsibility of compensation or payment of insurance benefits, and does not refund the insurance premium. If the policyholder or the beneficiary intentionally causes the death, disability or disease of the insured, the insurer shall not bear the responsibility of paying the insurance premium. If the policyholder has paid premiums for more than two years, the insurer shall return the cash value of the insurance policy to other entitled beneficiaries in accordance with the contract;
3. If, after the occurrence of an insurance accident, the policyholder, the insured or the beneficiary fabricates false causes of the accident or exaggerates the extent of the loss by means of forged or altered certificates, information or other evidence, the insurer shall not be liable to compensate or pay the insurance premiums for the portion of the misrepresentation. The insurer shall not be liable for compensation or payment of insurance premiums for the misrepresented part of the loss;
4. If the fraudulent behavior of the policyholder, the insured or the beneficiary is serious, they shall be subject to administrative penalties, and those who have violated the criminal law shall be held criminally liable.
Legal basis
The Chinese People's **** and National Code
Article 148 A party to fraudulent means, so that the other party in contravention of the true meaning of the circumstances of the implementation of the civil legal act, the fraudulent party has the right to request the people's court or arbitration institution to be revoked.
Article 149 The third party to commit fraud, so that a party in violation of the true meaning of the implementation of civil legal acts, the other party knew or should have known that the fraud, the fraudulent party shall have the right to request the people's court or arbitration institution to be revoked.