隐瞒第三方责任骗取医保基金问题探讨  

Exploration into the Issue of Concealing Third-Party Responsibility to Defraud Medical Insurance Funds

作　　者：张广田 

机构地区：[1]中国人民财产保险股份有限公司,北京100022

出　　处：《中国医疗保险》2024年第10期62-67,共6页China Health Insurance

摘　　要：国家医保局成立以来,持续巩固打击欺诈骗保高压态势。从各省医保局曝光案例来看,通过隐瞒第三方责任骗取医保基金仍是参保人欺诈骗保的高发领域。本文以医保部门曝光的典型案例为切入点,探讨参保人隐瞒第三方责任骗取医保基金存在的问题并提出改进建议。Since its establishment,the National Healthcare Security Administration has continued to consolidate the tough stance on cracking down on medical insurance fraud.However,according to the cases exposed by the provincial healthcare security administrations,defrauding medical insurance funds by concealing the thirdparty responsibility is still a field where fraud is common among the insured.This paper takes the typical cases exposed by the medical insurance departments to discuss the problems of the insured concealing the third party responsibility to defraud the medical insurance fund and puts forward suggestions for improvement.

关 键 词：隐瞒第三方责任 骗取 医保基金 改进建议 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]