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                                天津出台医保门特病新政 违规或涉嫌骗保将被罚

                                2015-07-27 23:07:07来源:遛天津编辑:晓敏
                                摘要:记者从本市人社部门了解到,为保障本市基本医疗保险门诊特定疾病(以下简称“门特病”)鉴定登记的真实性,规范门特病就医诊疗行为,维护医保基金安全和参保人员利益,日前

                                 JIZHECONGBENSHIRENSHEBUMENLEJIEDAO,WEIBAOZHANGBENSHIJIBENYILIAOBAOXIANMENZHENTEDINGJIBING(YIXIAJIANCHENG“MENTEBING”)JIANDINGDENGJIDEZHENSHIXING,GUIFANMENTEBINGJIUYIZHENLIAOXINGWEI,WEIHUYIBAOJIJINANQUANHECANBAORENYUANLIYI,RIQIAN,BENSHICHUTAI《TIANJINSHIRENMINZHENGFUGUANYUJINYIBUWANSHANYILIAOBAOXIANZHIDUDEYIJIAN》(JINZHENGFA〔2016〕17HAO),BINGYU8YUE1RIZHIXING。

                                天津出台医保门特病新政 违规或涉嫌骗保将被罚

                                JULEJIE,BENBANFASHIYONGDEMENTEBINGBAOKUO:TANGNIAOBING、PIANTAN、FEIXINBING、JINGSHENBING、AIZHENGFANGHUALIAO,QITAMENTEBINGSHISHINARUGUANLI。SHIRENLISHEBAOXINGZHENGBUMENZAIQUANSHIYIBAODINGDIANYILIAOJIGOUZHONG,XUANDINGZHUANYEXINGQIANG、ZHENDUANQUANWEIDEYILIAOJIGOU,ZUOWEIMENTEBINGFUCHAJIANDINGJIGOU。YILIAOBAOXIANJIANDUJIANCHAJIGOUZAIJIANDUJIANCHAGUOCHENGZHONG,FAXIANCANBAOHUANZHESHEXIANXUJIAMENTEDENGJI,HUOMENTEBINGJIUYIGOUYAOZHONGSHEXIANWEIFAWEIGUIXINGWEIDE,KEZANTINGQIMENTEBINGLIANWANGSHUAKAJIESUAN,BINGZUZHIQIDAOMENTEBINGFUCHAJIANDINGJIGOUJINXINGFUCHAJIANDING。

                                社会保险经办机构在经办管理过程中,发现参保患者涉嫌虚假门特登记或违法违规行为的,应转医疗保险监督检查机构处理并组织复查鉴定。对经复查鉴定确认属于虚假门特登记的参保患者,由医疗保险监督检查机构依法取消其门特登记,追回骗取的医疗保险金,处骗取金额2倍以上5倍以下的罚款,并纳入社会六六棋牌游戏下载征信管理系统。对原作出虚假门特病鉴定的医疗机构,由医疗保险监督检查机构依法追回骗取的医疗保险金,并处骗取金额2倍以上5倍以下的罚款,取消作出虚假门特鉴定医师的门特病鉴定资格。同时,纳入基本医疗保险总额管理满意度考核,并纳入社会征信管理系统。

                                标签:天津市,行政部门,医疗保险,糖尿病,参保人员

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