The detailed regulations on the implementation of the medical insurance fund supervision rules will be implemented in April, and these actions will be subject to punishment.
The National Medical Insurance Administration announced today the detailed rules for the implementation of the "Regulations on the Supervision and Management of the Use of Medical Security Funds", which will be enforced from April 1, 2026. The "Regulations on the Supervision and Management of the Use of Medical Security Funds" have been enforced since 2021, and the National Medical Insurance Administration has formulated detailed rules based on actual work to accurately crack down on fraudulent acts such as reselling drugs, swapping medical insurance drugs, and false medical treatment throughout the entire chain. According to the detailed rules, designated medical institutions and their staff who guide others to impersonate or falsely seek medical treatment, purchase medications through persuasion, false advertising, fee reduction, and provision of additional property, or organize others to defraud medical insurance to buy drugs and medical consumables, illegal acquisition, sale, etc., will be punished based on the situation of "assisting others in impersonating or falsely seeking medical treatment, buying drugs", with a fine of 2 to 5 times the amount defrauded, suspension of responsibilities of relevant departments of medical institutions for 6 months to 1 year involving the use of medical security funds in medical services.
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