射阳一起“欺诈骗保”典型案例被通报。。
<p><br/></p><p></p><section powered-by="xiumi.us" style="white-space: normal;font-size: 16px;max-width: 100%;box-sizing: border-box;background-color: rgb(255, 255, 255);line-height: 28.4444px;word-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;"><section powered-by="xiumi.us" style="max-width: 100%;box-sizing: border-box;word-wrap: break-word !important;"><section data-role="outer" label="Powered by 135editor.com" style="color: rgb(62, 62, 62);max-width: 100%;line-height: 25.6px;font-family: 微软雅黑;box-sizing: border-box !important;word-wrap: break-word !important;"><section data-role="outer" label="Powered by 135editor.com" style="max-width: 100%;box-sizing: border-box !important;word-wrap: break-word !important;"><section style="max-width: 100%;font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);text-indent: 2em;line-height: 1.75em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-tools="135编辑器" data-id="98947" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin: 10px auto;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="padding-right: 8px;max-width: 100%;box-sizing: border-box;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;flex-direction: column;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 5px;margin-bottom: 5px;max-width: 100%;box-sizing: border-box;border-width: 1px;border-style: solid;border-color: rgb(0, 0, 0);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;line-height: 1.75em;text-indent: 2em;overflow-wrap: break-word !important;"><section style="padding: 1em;max-width: 100%;box-sizing: border-box;display: flex;flex: 1 1 0%;overflow-wrap: break-word !important;"><section data-autoskip="1" style="max-width: 100%;font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;color: rgb(0, 0, 0);word-break: break-all;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">一、关于定点医疗机构欺诈骗保的典型案例</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例1：滨海界牌医院为他人冒名就医提供便利骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2020年6月，滨海界牌医院存在未核验参保人员人证卡，为他人冒名就医提供便利，涉及违规金额1154元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《滨海县基本医疗保险定点医疗机构服务协议》及有关规定，作出如下处理：1.暂停联网结算1个月；2.追回违规金额1154元；3.罚款3462元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例2：响水光明中医院串换诊疗项目骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2019年1月至12月，响水光明中医院以串换诊疗项目的方式申报结算医保基金，涉及违规金额46500元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《响水县医疗保险定点医疗机构服务协议》第五十条规定，作出如下处理：1.追回违规金额46500元；2.扣除违约金46500元；3.限期整改。</span></p></section></section></section></section><section style="margin-top: 5px;margin-bottom: 5px;max-width: 100%;line-height: 1.75em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: -20px;margin-right: -5px;max-width: 100%;display: flex;flex-direction: column;flex-shrink: 0;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section><section style="margin-top: -7px;max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section></section></section></section></section></section></section></section></section></section><section style="max-width: 100%;font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);text-indent: 2em;line-height: 1.75em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-tools="135编辑器" data-id="98947" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin: 10px auto;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 5px;margin-bottom: 5px;padding-right: 8px;max-width: 100%;box-sizing: border-box;line-height: 1.75em;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;flex-direction: column;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-width="98%" style="max-width: 100%;box-sizing: border-box;background: rgb(255, 216, 0);width: 655.609px;height: 5px;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section><section style="max-width: 100%;box-sizing: border-box;border-width: 1px;border-style: solid;border-color: rgb(0, 0, 0);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow-wrap: break-word !important;"><section style="padding: 1em;max-width: 100%;box-sizing: border-box;display: flex;flex: 1 1 0%;overflow-wrap: break-word !important;"><section data-autoskip="1" style="max-width: 100%;font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;color: rgb(0, 0, 0);word-break: break-all;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">二、关于定点零售药店欺诈骗保的典型案例</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例3：滨海县恒安药房虚构医药服务、串换药品骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2020年3月，滨海县恒安药房通过虚构医药服务、串换药品等方式骗取医保基金，涉及违规金额16900元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《滨海县基本医疗保险定点零售药店服务协议》的规定，作出如下处理：1.暂停联网结算3个月；2.追回违规金额16900元；3.罚款33800元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例4：大丰佳民药店刷卡套现骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2020年1月至4月，盐城市大丰佳民药店存在刷卡套取现金的行为。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《盐城市区医疗保险定点零售药店服务协议》第二十二条的规定，作出如下处理：1.终止医保服务协议，取消医保定点；2.扣除违约金30000元；3.将相关问题线索移交公安机关侦办。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例5：响水苏仁大药房有限公司药品进销存不符骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2020年1月，响水苏仁大药房有限公司的药品进销存与上报医保系统数据不符，涉及违规金额4663.43元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《响水县医疗保险定点零售药店服务协议》的第二十三条、二十四条的规定，作出如下处理：1.追回违规金额4663.43元；2.扣除违约金3000元；3.暂停联网结算1个月；4.违规情形纳入医保质量年度考核。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例6：盐城国瑞崇德大药房有限公司店内陈列保健品、药品进销存数据不符骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2020年4月，盐城国瑞崇德大药房有限公司店内陈列保健品、化妆品。另医保药品实际销售情况、经营药品采购票据与上报进销存管理数据不一致，涉及违规金额17700元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《盐城市基本医疗保险定点零售药店服务协议》有关规定，作出如下处理：1.追回违规金额17700元；2.扣除违约金3770.01元；3.暂停联网结算1个月。</span></p></section></section></section></section><section style="max-width: 100%;display: flex;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: -20px;margin-right: -5px;max-width: 100%;display: flex;flex-direction: column;flex-shrink: 0;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section><section style="margin-top: -7px;max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section></section></section></section></section></section></section></section></section><section style="max-width: 100%;font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-tools="135编辑器" data-id="98947" style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin: 10px auto;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 5px;margin-bottom: 5px;padding-right: 8px;max-width: 100%;box-sizing: border-box;line-height: 1.75em;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;flex-direction: column;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;display: flex;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section data-width="98%" style="max-width: 100%;box-sizing: border-box;background: rgb(255, 216, 0);width: 655.609px;height: 5px;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section><section style="max-width: 100%;box-sizing: border-box;border-width: 1px;border-style: solid;border-color: rgb(0, 0, 0);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow-wrap: break-word !important;"><section style="padding: 1em;max-width: 100%;box-sizing: border-box;display: flex;flex: 1 1 0%;overflow-wrap: break-word !important;"><section data-autoskip="1" style="max-width: 100%;font-size: 14px;letter-spacing: 1.5px;line-height: 1.75em;color: rgb(0, 0, 0);word-break: break-all;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">三、关于参保个人欺诈骗保的典型案例</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例7：阜宁县郭墅镇沙河村卫生室负责人李某盗刷他人社保卡骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，参保人何某林长期在外地工作，从未在阜宁县郭墅镇沙河村卫生室就医购药。2018年2月至2019年7月，何某林社保卡被沙河村卫生室盗刷64次，涉及违规金额653.75元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《盐城市基本医疗保险定点医疗机构服务协议》第六十四条的规定，作出如下处理：1.追回违规金额653.75元；2.扣除违约金196.13元；3.对沙河村卫生室负责人李某领通报批评。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;color: rgb(255, 0, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例8:参保人员将不符合医保报销规定医疗费用报销骗取医保基金案</span></strong></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;color: rgb(255, 0, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2019年5月，倪某青与徐某兵因纠纷发生冲突，导致徐其兵左侧下肢骨折，后在射阳县人民医院住院治疗。双方就医疗费用达成约定，倪某青在承担徐其兵所有治疗费用之外，赔偿徐某兵损失一万元。2019年8月，倪某青儿子倪某龙提供虚假证明，将徐某兵在射阳县人民医院住院发生的医疗费用送至射阳县医保中心报销，涉及违规金额33244.44元。</span></strong></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;color: rgb(255, 0, 0);box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门根据群众举报，通过多方调查取证，依据《行政执法机关移送涉嫌犯罪案件的规定》第三条规定，将相关问题线索移交公安机关侦办。</span></strong></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例9：蔡某松冒用他人社保卡就医购药骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2017至2019年，蔡某松冒用参保人员蔡某桂社保卡多次在盐城市第三人民医院就医购药，实际发生医疗费用49298.45元，涉及违规金额25319.78元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《行政执法机关移送涉嫌犯罪案件的规定》第三条规定，将相关问题线索移交公安机关侦办。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">案例10：参保人员赵某军利用民政救助身份骗取医保基金案</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">经查，2018年1月以来，参保人员赵某军利用本人低保身份，在盐城市第三人民医院重复就医购药，涉及违规金额196118.24元。</span></p></section><section style="max-width: 100%;font-size: 17px;text-indent: 2em;line-height: 1.75em;font-family: 微软雅黑, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><p style="max-width: 100%;min-height: 1em;cursor: text;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;"><span style="max-width: 100%;cursor: text;font-size: 14px;box-sizing: border-box !important;overflow-wrap: break-word !important;outline: none 0px !important;">医保部门依据《行政执法机关移送涉嫌犯罪案件的规定》第三条规定，将相关问题线索移交公安机关侦办。</span></p></section></section></section></section><section style="max-width: 100%;display: flex;justify-content: flex-end;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: -20px;margin-right: -5px;max-width: 100%;display: flex;flex-direction: column;flex-shrink: 0;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section><section style="margin-top: -7px;max-width: 100%;transform: rotate(45deg);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(255, 228, 77);background-image: initial;background-position: initial;background-size: initial;background-repeat: initial;background-attachment: initial;background-origin: initial;background-clip: initial;overflow: hidden;overflow-wrap: break-word !important;"><br style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/></section></section></section></section></section></section></section></section></section></section><p style="max-width: 100%;min-height: 1em;text-align: right;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></p></section></section></section></section></section><p></p><h1 style="white-space: normal;font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="margin-right: 8px;margin-left: 8px;text-align: center;line-height: normal;overflow-wrap: break-word !important;"><strong style="color: rgb(89, 87, 87);font-family: Helvetica Neue, Helvetica, Hiragino Sans GB, Microsoft YaHei, Arial, sans-serif;overflow-wrap: break-word !important;">- end -</strong><br style="overflow-wrap: break-word !important;"/></section><section style="margin-right: 8px;margin-left: 8px;text-align: center;line-height: normal;overflow-wrap: break-word !important;"><br style="overflow-wrap: break-word !important;"/></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></h1><h1 style="white-space: normal;font-family: -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="overflow-wrap: break-word !important;"><section style="margin-right: 8px;margin-left: 8px;letter-spacing: 0px;line-height: 1.5em;overflow-wrap: break-word !important;"><span style="font-size: 12px;color: rgb(89, 87, 87);overflow-wrap: break-word !important;">▍图文来源：盐城医保 ▍</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></h1><p><br/></p><link rel="stylesheet" href="http://www.320924.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_ymF" id="wcn_editor_css"/>
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