The Chongqing Public Security Bureau of China recently cracked two cases of suspected fraud in private hospitals, arrested 143 people, and the amount involved was as high as 330 million yuan (RMB, the same below, about 620 billion yuan).
According to the surging news report, Luo Po Su, Chief Criminal Investigation Corps of the Chongqing Public Security Bureau, introduced at a press conference on Friday (October 27) that in February this year, the Chongqing police received a clue from the Chongqing Municipal Audit Bureau to transfer clues: Yongchuan Wolong Hospital is suspected of using drugs to increase medications through fictional virtuality, and deceives huge national medical insurance funds.Due to the huge amount of the case and the complicated case, the Municipal Public Security Bureau established the "3. 10" task force for the first time to carry out case investigation.
After investigation, Wolong Hospital was invested and established by the suspect Wang, and Wang hired the suspect Luo to serve as the dean of Wolong Hospital.Since 2016, the two have introduced the employees of Yongchuan Wolong Hospital to introduce relatives, friends, guest solicitation, and the referral of township health centers to vigorously develop more than 9,000 "family doctors".Meeting from time to time in a period of irregularities, promoting hospitalization once or twice a year, it only takes 300 to 500 yuan to "dry the treatment".The hospitalization cost document was uploaded to the medical insurance audit system, and a total of 490 million yuan was reimbursed, of which 230 million yuan was suspected of fraud.
Luo has different differences with Wang due to dividends.Da Kang Hospital, another private hospital in the local area, invited Luo to be the president of Dakang Hospital.Since 2019, Luo and others have developed more than 4,000 "Jiu'an Members" with the same means. The medical staff of Yongchuan Dakang Hospital fraudulently fraudulent the National Medical Insurance Fund by the same way, reimbursing a total of 220 million yuan in medical insurance funds, of which the suspected fraud medical insurance fund 1100 million yuan.
Recently, the task force assembled more than 300 police forces to capture 143 people, core backbones, financial personnel, and personnel involved at all levels in one fell swoop.More than 83 million yuan in funds involved.
Luo confessed that their hospitals were tense and clear division of labor. In order to deceive the medical insurance fund illegal profits, the full process of the hospital was fraudulent.Free medical examinations, in fact, to scam the National Medical Insurance Fund after obtaining medical insurance information.
He also said that the hospital required employees to introduce one or five patients for hospitalization and implement a reward and punishment mechanism every month.Projects, counterfeit medical records, and more hospitalized days empty beds; the examination department is responsible for modifying the patient's examination coefficient indicator to achieve the purpose of deceiving patients to handle hospitalization;2. Consumption; the hospital office is responsible for sorting out medical insurance medical records, applying for national medical insurance funds. In addition to the daily operating costs of the hospital, the medical insurance funds obtained by fraud are all used for shareholders' dividends and market commission.
