Announcement of flight inspection of medical insurance fund in 2022, and the rational use of medical insurance fund has achieved positive results.

CCTV News:On June 13th, the National Medical Insurance Bureau announced the flight inspection of the medical insurance fund in 2022. In 2022, the flying inspection focused on large medical institutions in areas with rich medical resources, pointed out the typical problems in the use of medical insurance funds by these institutions, urged designated medical institutions to make serious, comprehensive and solid rectification, and made phased progress in standardizing the use of funds in the medical insurance field.

In 2022, the National Medical Insurance Bureau, together with the Ministry of Finance, the National Health and Wellness Commission, the State Administration of Traditional Chinese Medicine and other departments, organized 24 flight inspections, including the special flight inspection of tongji hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology and the annual flight inspection to 23 provinces across the country. From the inspection situation, the designated medical institutions continue to improve the internal management system, standardize the medical staff’s diagnosis and treatment behavior, and achieve positive results in more rational use of medical insurance funds, but still find some problems.

The National Flight Inspection Team randomly selected 48 designated medical institutions, including 40 third-class public hospitals, 3 third-class private hospitals and 5 private medical institutions below the second level. After inspection, the following problems were found: 1. Repeated charges, over-standard charges and itemized charges, and 48 medical institutions had such problems. 2. Swapping drugs, medical consumables, diagnosis and treatment items and service facilities, 46 medical institutions have such problems. Third, medical expenses that are not covered by the medical insurance fund are included in the medical insurance fund settlement, and 43 medical institutions have such problems. Fourth, over-diagnosis, over-examination and over-prescribing in violation of the diagnosis and treatment norms, 39 medical institutions have such problems. In addition, some medical institutions have decomposed hospitalization, drugs and medical consumables are inconsistent with each other, and the national policy of centralized procurement of pharmaceutical consumables has not been strictly implemented, and other illegal and illegal issues such as high dependence on sick groups and low-standard hospitalization under the disease-based payment model; Some medical institutions have the problem of fictitious medical services.