“医保返利”诱导购药是骗局！
<section data-role="outer" label="edit by 135editor" style="margin: 0px 0px 24px;padding: 0px;outline: 0px;max-width: 100%;color: rgba(0, 0, 0, 0.9);font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;font-size: 17px;letter-spacing: 0.544px;text-align: justify;text-wrap: wrap;background-color: rgb(255, 255, 255);box-sizing: border-box !important;overflow-wrap: break-word !important"><section style="margin-top: 0px;margin-right: 0px;margin-bottom: unset;margin-left: 0px;padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-id="151260" data-type="lspecial02" data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-md5="b7470" style=";padding: 0px 0px 5px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;text-align: left"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;display: inline-block;vertical-align: middle"><section data-md5="b7470" style=";padding: 3px 10px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;border-width: 1px;border-style: solid;border-color: rgb(106, 165, 255)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;color: rgb(0, 0, 0);font-size: 16px;letter-spacing: 1px;line-height: 24px"><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: 17px"><strong style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">案情摘要：</strong></span></section></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;background-color: rgb(107, 166, 255);border-radius: 50%;width: 12px;height: 12px;transform: translate(0px, 0px)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(162, 198, 255);border-radius: 50%;transform: translate(5px, 0px)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;height: 1px;background: rgb(107, 166, 255)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section></section></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">“有人经常拿好几张社保卡在某门诊部配药，这会不会有什么猫腻？</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">”接到举报后，杭州市医保部门执法人员立即开展调查。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">经查明，该门诊部因虚假结算骗取医疗保障基金20938.97元，并存有非正常盈余药品202盒，涉及金额15863.46元。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">杭州市医保部门随即对其解除医保服务协议，3年内不再受理该机构定点申请。</span><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p></section></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"></section><section style="margin-top: 0px;margin-right: 0px;margin-bottom: unset;margin-left: 0px;padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-id="151260" data-type="lspecial02" data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-md5="b7470" style=";padding: 0px 0px 5px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;text-align: left"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;display: inline-block;vertical-align: middle"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;background-color: rgb(107, 166, 255);border-radius: 50%;width: 12px;height: 12px;transform: translate(0px, 0px)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(162, 198, 255);border-radius: 50%;transform: translate(-5px, 0px)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section><section data-md5="b7470" style=";padding: 3px 10px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;border-width: 1px;border-style: solid;border-color: rgb(106, 165, 255)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;color: rgb(0, 0, 0);font-size: 16px;letter-spacing: 1px;line-height: 24px"><p data-md5="b7470" style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: 17px"><strong style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">案件详情：</strong></span></p></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;background-color: rgb(107, 166, 255);border-radius: 50%;width: 12px;height: 12px;transform: translate(0px, 0px)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(162, 198, 255);border-radius: 50%;transform: translate(5px, 0px)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;height: 1px;background: rgb(107, 166, 255)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section></section></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;text-align: left;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">接到举报后，执法人员通过比对监控记录和医保结算记录，发现多名参保人的社保卡在该门诊部频繁就诊，且每次均会有几百甚至上千元的药品上传医保结算。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">经调查发现，杭州某门诊部负责人高某，以现金返利等方式，诱导8名参保人持本人及他人多张社保卡，在其门诊部虚假结算药品和诊疗项目。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">有就医者表示，他经常去这家诊所看病买药，与老板高某熟识后，只要带上社保卡就诊，每次医保结算时，“患者”既可以不支付医疗费用个人负担部分，还会获得老板几十到一百元不等的“返利”。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">不少人就是被高某的“小诱惑”勾起了“歪心思”，带着自己的甚至家人、朋友、邻居的社保卡，经常“光顾”这家诊所“看病购药”。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">“我每次都是把几张社保卡直接给老板，”被调查询问的参保人如实说道，“他用这些社保卡具体结算了什么我也不清楚，票据反正没有给过我，有时候药也不会给我。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">”</span></p><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;text-align: left;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p></section></section><section style="margin-top: 0px;margin-right: 0px;margin-bottom: unset;margin-left: 0px;padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-id="151260" data-type="lspecial02" data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><section data-md5="b7470" style=";padding: 0px 0px 5px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;text-align: left"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;display: inline-block;vertical-align: middle"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;background-color: rgb(107, 166, 255);border-radius: 50%;width: 12px;height: 12px;transform: translate(0px, 0px)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(162, 198, 255);border-radius: 50%;transform: translate(-5px, 0px)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section><section data-md5="b7470" style=";padding: 3px 10px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;border-width: 1px;border-style: solid;border-color: rgb(106, 165, 255)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;color: rgb(0, 0, 0);font-size: 16px;letter-spacing: 1px;line-height: 24px"><p data-md5="b7470" style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: 17px"><strong style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">案<strong style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">件解析</strong>：</strong></span></p></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;background-color: rgb(107, 166, 255);border-radius: 50%;width: 12px;height: 12px;transform: translate(0px, 0px)"><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 12px;height: 12px;border-width: 1px;border-style: solid;border-color: rgb(162, 198, 255);border-radius: 50%;transform: translate(5px, 0px)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section><section data-md5="b7470" style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;height: 1px;background: rgb(107, 166, 255)"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section></section></section></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;text-align: left;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;box-sizing: border-box !important;overflow-wrap: break-word !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">根据《医疗保障基金使用监督管理条例》规定，定点医药机构诱导、协助他人冒名或者虚假就医、购药，或者虚构医药服务项目的，由医疗保障行政部门责令退回，处骗取金额2倍以上5倍以下的罚款；</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">责令定点医药机构暂停相关责任部门6个月以上1年以下涉及医疗保障基金使用的医药服务，直至由医疗保障经办机构解除服务协议。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">个人冒名使用他人医疗保障凭证就医、购药的，或者虚构医药服务项目，造成医疗保障基金损失的，责令退回；</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">属于参保人员的，暂停其医疗费用联网结算3个月至12个月；</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">骗取医疗保障基金支出的，还应当由医疗保障行政部门处骗取金额2倍以上5倍以下的罚款。</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;font-size: var(--articleFontsize);letter-spacing: 0.034em">根据《最高人民法院 最高人民检察院 公安部关于办理医保骗保刑事案件若干问题的指导意见》，上述行为还可依照刑法第二百六十六条的规定，以诈骗罪定罪处罚。</span><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></p></section></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">最终，杭州市医保部门责令该门诊部退回医疗保障基金36802.43元，并解除医保服务协议。对于伙同作案的参保人员，根据情节严重性，作出追回医保基金损失、2-5倍骗取金额行政罚款和暂停医保费用联网结算3-12个月等处罚。案件同步移送公安机关进一步调查。</section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"><br style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important"/></section><section style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important">小编再次提醒广大参保朋友们，医保基金的使用安全涉及广大人民群众的切身利益，守好“救命钱”的同时，也要警惕各种诱导式的“洗脑”，避免被卷入欺诈骗保的旋涡。如您发现类似欺诈骗保行为，请及时拨打国家局打击欺诈骗保举报电话010-89061396、010-89061397，或向当地医保部门及时举报。线索一经查实，将按规定予以奖励，奖励金额最高可达20万元。</section></section><p data-style="margin-top: 16px; margin-bottom: 0px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; text-wrap: wrap; background-color: rgb(255, 255, 255); font-size: 16px; visibility: visible;" style="margin-top: 16px;margin-bottom: 0px;padding: 0px;outline: 0px;max-width: 100%;clear: both;min-height: 1em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-align: justify;text-wrap: wrap;background-color: rgb(255, 255, 255);font-size: 16px;visibility: visible;box-sizing: border-box !important;overflow-wrap: break-word !important;color: rgb(163, 163, 163) !important"><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;caret-color: rgb(255, 0, 0);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;text-align: start;color: rgb(109, 178, 224);visibility: visible">┃</span><span style=";padding: 0px;outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;caret-color: rgb(255, 0, 0);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;text-align: start;color: rgb(160, 160, 160);visibility: visible">来源：国家医保局</span></p><p><br/></p><link rel="stylesheet" href="//www.dafuping.cn/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_wku" id="wcn_editor_css"/>
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