Deputy Director of the Anhui hospital to defraud the national health fund for hospitalized patients ' families | cheating | hospitals _ news
Problem: families of patients to see a doctor are "live" in lujiang, Vice President of a private hospital is suspected of insurance fraud was arrested
Angolan online according to Anhui daily messages do not need to be hospitalized, doctors let patients go through the admission procedures, patients to see a doctor, the family was also handling hospital procedures, often appears in a private hospital in lujiang County such a strange thing. The original hospital is within a region, using "little doctor", "hospital medical treatment the whole family", defrauding the national health compensation fund, so that the "hospital reimbursement" became their means of profit. Recently, the former President and Vice President was arrested on charges of fraud by lujiang County Procuratorate approved the arrest.
For hospitalized patients without hospital procedures
Starting from 2012 and 2013, and Wu the private hospital in lujiang County, respectively President and Vice President, is responsible for the overall work, Wu in charge of hospital finance. In order to increase hospital profits and personal incomes, since December 2013, two people playing the idea of compensation for defrauding the national health.
Two people directed doctor Zhu Mou, and King a, and Xue a, and Dr a, will came to visits of patients "small disease dazhi" handle hospital, even in patients discharged Shi thought its family do free check for by, let family also handle hospital procedures, virtual open treatment drug, making false hospital records information,, by Deputy Dean Wu a took with false of hospital information to lujiang urban and rural residents cooperation medical management center claims, received medical compensation gold.
One patient was confirmed, own around February 2015 because of high blood pressure, blood vessels in the legs does not pass, to a hospital for treatment. Following diagnosis, the doctor wrote a lot of traditional Chinese medicine, and urged them to apply for the admission procedures, says it will be able to claim, less money. Doctors are persuaded by the patients for the hospital procedures, but did not actually in hospital, got a prescription and went home. More than 10 days later, he again went to the hospital pharmacy, doctors who let him go through the discharge formalities. The medical process, the patient spending 200 Yuan, and at the medical center of the hospital expenses, up as much as 3000 Yuan.
Patients go to the doctor, he made family "lived"
Zhu was the rehabilitation of the hospital doctor, according to the statement, their departments usually have a family care of patients treated, some family members asked doctors to help their own check. Zhu will ask the family to shoot a film, if shooting reported problems, and he is willing to treat, he will open up for family members of patients with inpatient appointment card. If not hospitalized, the President also asked Zhu to family-run hospital procedures.
Patients, Wang said he had spinal well in the hospital. Meanwhile, doctor Zhu for the clock family go through the admission procedures, saying that medical expenses can be reimbursed, less money for themselves. So Wang to Zhu doctor provides Bell's identity and apply for admission procedures. And in fact their families did not stay in hospital.
False 58 claims fraud of more than 100,000 yuan
The hospital is using this method to defraud the nation's massive health compensation fund, real benefits for patients, will not dispute, it has not been found.
Preliminary identified by only two years, room a, Wu and others for such false 58 participating funds, has fooled a medical compensation fund for more than 100,000 yuan. After getting compensation, Vice President Wu often received medical compensation into information management of the hospital in his own bank account and then according to the prior agreement of the Commission, in the form of payroll share.
In recent days, defrauding the national health compensation, and Wu was arrested for suspected fraud, Zhu, who the doctors involved by reason of their accomplice, pleaded guilty to a better attitude, was released on bail pending trial.
Source: China Online-Anhui commercial news
Responsible editor: Gao Yuying
Article keywords:Insurance fraud hospital
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安徽医院一副院长为骗取国家医疗补偿基金让患者家属住院|骗保|医院_新闻资讯
遇难题：患者去看病 家属竟被“住了院” 庐江一民营医院正副院长涉嫌骗保被批捕
中安在线讯 据安徽商报消息 不需要住院，医生也让患者办理住院手续，患者来看病，家属也被办理住院手续，庐江县某民营医院经常出现这样的怪事。原来，是医院内有人利欲熏心，利用“小病大医”、“一人治病全家住院”等手段骗取国家医疗补偿基金，从而使“住院报销”成为其牟利手段。近日，该院原院长和副院长涉嫌诈骗罪被庐江县检察院批准逮捕。
为无需住院的患者办理住院手续
从2012年和2013年起，房某和吴某分别担任庐江县这家民营医院的院长和副院长，房某负责全面工作，吴某分管医院财务。为了增加医院盈利和个人收入，2013年12月以来两人打起了骗取国家医疗补偿金的主意。
两人指使医生朱某、王某、薛某、杨某等将前来就诊的病人“小病大治”办理住院，甚至在病人出院时以为其家属做免费检查为由，让家属也办理住院手续，虚开治疗药物，制作虚假住院病历资料等，由副院长吴某拿着虚假的住院资料到庐江县城乡居民合作医疗管理中心报销，领取医疗补偿金。
一位患者证实，自己在2015年2月左右因为高血压、腿部血脉不通，到房某所在医院治疗。医生诊断后开了很多中药，并劝其办理住院手续，说这样就能多报销，自己少花钱。在医生的劝说下该患者办理了住院手续，但实际上并没住院，拿了药就回家了。十几天后他再次前往医院拿药，医生才让他办理了出院手续。整个医疗过程，该患者支出200元，而该医院在医管中心的报销金额却达到3000元之多。
患者去看病，竟让家属“住了院”
朱某曾是该医院康复科主治医生，据其供述，来其科室治疗的病人通常会有家属陪护，有些家属会要求医生帮自己检查一下。朱某便会要求家属去拍片子，如果拍片报告有问题，自己也愿意治疗，他便为患者家属开住院证。如果不愿意住院治疗，院长房某也会让朱某给家属办住院手续。
患者王某说，自己曾因腰椎不好在该院住院。其间，朱医生让其家属钟某某也办理住院手续，说这样医药费可以多报销点，自己就少掏点钱。于是王某便向朱医生提供了钟某某的身份信息并办理了住院手续。而事实上其家属根本没有住院。
虚报58人次报销骗保10多万元
该医院就是用这种方法，骗取了国家大量医疗补偿基金，因患者得到实际利益，不会因此产生纠纷，因此一直未被发现。
经初步查明，仅两年多时间，房某、吴某等人以上述方法虚报58人次参合基金，共骗得医疗补偿基金十余万元。拿到补偿金后，副院长吴某往往将所领的医疗补偿金打入以自己身份信息办理的医院银行账户中，然后再按照事先约定的提成，以工资发放的形式进行分赃。
近日，骗取国家医疗补偿金的房某、吴某因涉嫌诈骗罪被依法逮捕，朱某等几名涉案医生因系从犯，认罪态度较好，被取保候审。
来源：中安在线-安徽商报
责任编辑：高玉营
文章关键词： 骗保 医院
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