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style="color:#1f5781;">江蘇持續開展專項治理強化日常監督嚴防醫?；鹋苊暗温?!--<$[標題名稱(html)]>end--></h1><div class="c-conten-top"> <i>發布日期：2021-11-23</i><i>信息來源：中國紀檢監察報</i><i>字號：[ <a href='javascript:doZoom(16)'>大</a> <a href='javascript:doZoom(14)'>中</a> <a href='javascript:doZoom(12)'>小</a> ]</i><i class="e e3"> <div class="share_box"> <div class="slideDown" style="height: 43px;"> <span class="share">分享<b></b></span> <ul> <li class="row"> <div class="social-share" data-initialized="true"> <p><a href="#" class="social-share-icon icon-qzone ico02">QQ空間</a></p> <p><a href="#" class="social-share-icon icon-weibo ico01">新浪微博</a></p> <p><a href="#" class="social-share-icon icon-qq ico06">QQ</a></p> <p><a href="#" class="social-share-icon icon-wechat ico03">微信</a></p> </div> </li> </ul> </div> </div> <script>window._bd_share_config = { "common": { "bdSnsKey": {}, "bdText": "", "bdMini": "2", "bdMiniList": false, "bdPic": "", "bdStyle": "0", "bdSize": "16" }, "share": {}, "image":{ "viewList":'', "viewText":'' , 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rgb(62, 62, 62); text-indent: 2em; font-family: 楷體, 楷體_GB2312, SimKai; background-color: rgb(255, 255, 255);">圖為近日，泰州醫藥高新區（高港區）紀（工）委監委第十派駐紀檢監察組聯合醫保執法人員到刁鋪街道社區衛生服務中心，抽查慢性病患者和高齡人群醫?？ㄊ褂糜涗?、就診住院、藥品使用等信息，嚴防醫?；稹芭苊暗温?。姜兆剛攝</span></p><p style="padding: 0px; text-align: justify; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><strong><span style="text-align: justify; color: rgb(62, 62, 62); background-color: rgb(255, 255, 255);"><br/></span></strong></p><p style="padding: 0px; text-align: center; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><a href="/picture/0/2111230728057681310.jpg" target="_blank"><img width="600" height="450" title="22.jpg" src="/picture/0/s2111230728057681310.jpg"/></a></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><span style="font-family: 楷體, 楷體_GB2312, SimKai;">蘇州市吳中區紀委監委開展醫?；鸨O管專項整治行動，全力護好人民群眾“救命錢”。圖為該區紀委監委辦案人員對一起涉嫌騙保的案件進行調查核實。楊凱攝</span></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><span style="font-family: 楷體, 楷體_GB2312, SimKai;"><br/></span></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">醫?；鹗侨嗣袢罕姷摹翱床″X”、“救命錢”，但長期以來，不少機構和個人把它當成“唐僧肉”，想方設法套取者有之，挖空心思雁過拔毛者有之，直接挪用者有之，亂象叢生，影響惡劣。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">從去年部分地區小切口試點騙取醫?；饘ｍ椫卫砉ぷ?，到今年省內全面鋪開，江蘇省各級紀委監委嚴肅查處勾結騙保、套取基金等行為，以查辦案件為抓手，強化日常監督，推動醫?；鸨O管制度更加規范，切實維護群眾的切身利益。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><strong>倒查數據、起底問題，嚴查徹處形成持續震懾</strong></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“對吳江區社區服務中心負責人董某、李某移送公安機關以詐騙罪刑事立案，對20名在職黨員干部和監察對象予以黨紀政務立案?！苯?，蘇州市吳江區紀委監委查辦了一起公職人員參與欺詐騙保典型案件，因問責力度大、范圍廣，在當地引發不小震蕩。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">一家基層衛生站、一所自營商店、若干業務介紹人——靠著簡單如“草臺班子”似的設置，蘇州市吳江區社區服務中心長期虛列患者自付金額、“空刷”醫?？?，吸引群眾和黨員干部就醫、購買藥品和生活用品，將大量患者醫?？粼谛l生站，長期套用醫保統籌資金，經查，共2386人違規使用醫?；?，涉案金額達591.5萬元。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">案件查處源于醫保數據倒查，蘇州市紀委監委運用省市兩級信息化平臺，對2013年至2020年醫保數據嚴格篩查。通過比對就診結算異常、病種數量異常、統籌基金異常、疑似掛床住院等17個監督規則，梳理疑似問題信息10878條，為糾治欺詐騙保行為提供“靶向藥”。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">萬份異常數據中，最先引起注意的是兩名“80后”監察對象，7年間，兩人刷卡次數均超過1000次，“正值壯年，兩三天就得看一次病，而且大都在同一家基層醫院就診，著實反常?！?/p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">線上的數據信息，需要線下核查證據印證。在詳實的醫?？ㄊ褂脭祿媲?，葉某很快承認其借出醫?？樗丝床〉氖聦?；而張某則交代了其在服務中心超市購買生活物品，使用醫?？ńY算的情況。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">兩名涉案人均提到社區服務中心一名叫“王姐”的刷卡聯絡人。辦案人員再次對刷卡次數較多的30份數據進行分析比對時，發現有14份數據與服務中心有關。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">線索指向清晰，醫生虛開、多開藥品和診療檢查項目、造假病歷、多開住院天數空掛床位，檢驗科修改病人檢查系數指標，護理部編造護理記錄、虛假執行醫囑、虛假計費……一起內外勾結欺詐騙保的案件由此浮出水面。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“欺詐騙保行為隱蔽性強、相關信訪舉報極少，必須主動出擊，變‘等米下鍋’為‘找米下鍋’?！苯K省各級紀檢監察機關通過倒查數據線上分析比對、線下“室組地”聯動調查核實，精準有效發現問題線索，以點帶面推動專項整治取得更大成效。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">堅持聯動起底督辦問題線索，江蘇省紀委監委機關牽頭，壓緊壓實主體責任和監督責任，一方面駐省衛健委紀檢監察組督促省衛健委落實行業主管部門責任，推動省醫保局常態化專項執法檢查，并建立問題線索相互移送機制，及時移送2019年以來全省行政處罰、暫?；蚪獬t保協議等處罰件，另一方面各設區市同步起底篩查信訪反映、醫保部門移送等問題線索。對收集的6396件處罰件、509件醫保信訪舉報逐一過堂研判，梳理出512件問題線索。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">今年以來，全省共查處欺詐騙保問題354起，給予黨紀政務處分163人，追回醫?；?.33億元，督促各地通報曝光典型案例42起75人，持續釋放越往后執紀越嚴的強烈信號。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><strong>監督前移、堵塞漏洞，管住職能部門任性權力</strong></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">分析多起案件成因，省紀委監委相關工作人員談道，涉案人員大多主觀認識出現偏差，覺得醫保詐騙中好像沒有受害者——醫生多開藥可以完成定額指標任務，患者刷卡換取生活用品貼補家用，從參保者到醫療機構，每個人都得到了“實惠”，于是紛紛將醫?；鹨暈樵鍪战輳?，鉆政策漏洞，分食醫?！按蟮案狻?。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">保護醫?；鸢踩\行，人是關鍵因素。要通過以案促改強化對醫療機構、職能部門的監管，抓早抓小，做到小過即問、小錯即糾、防微杜漸。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">在全國首批醫療保險制度改革“兩江”試點城市之一的鎮江市，該市紀委監委針對醫生“一支筆”等問題敦促市醫保局將監督關口前移，通過開發、優化醫保智能監控事前事中系統、實時警告，及時識別、發現跨醫療機構頻繁就診、超量開藥、超量檢查等違規行為。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“病人就診前，系統自動彈出患者近30天的開藥、檢查、住院信息?！辨偨屑o委監委黨風政風監督室主任葉紅介紹，問診如果觸發審核規則，系統還會跳出提示框，比如之前開的藥品沒有使用完，醫生再開同類藥品，系統將顯示剩余藥量。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">就診人員確實因病情需要，醫生或藥店可填寫緣由跳過提示，但對該筆可疑處方，醫保監管部門及經辦機構將從后臺提取數據，作進一步核查處理。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">官方警告不僅倒逼醫院加強管理、規范醫療行為，還對醫患雙方產生約束力，督促雙方按規矩辦事。前不久媒體曝光了“12·01”跨省詐騙醫?；鸢?，其中一名涉案人曾試圖在一系統試點基層衛生院多開藥，盡管撒潑打滾、在診室哭喊，卻被醫生堅定回絕：“強行開藥，我們有被調查的風險?！?/p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">目前，鎮江市區范圍二級以上醫療機構、社區衛生服務中心、醫生工作站已實現系統全覆蓋。僅今年前三季度，系統事前提示共計發出670萬條左右；事中審核共計審核可疑問題單據2.5萬條，向紀檢監察機關移交問題線索84條。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">用信息化管人，用制度管錢。醫?；疰湕l長，要從源頭上防止醫?；鸬牧魇?，必須從嚴和細上著手，以制度填補費用監控、基金撥付、待遇審核及支付等環節的漏洞。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">此前，鎮江市醫療保險基金管理中心一工作人員長期優親厚友，利用職務便利，越過審核人員，自行審核簽字并交窗口報銷，僅零星醫藥費就報銷了61筆，同時在缺少發票、診斷證明書等情況下，報銷外購藥物等費用。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">監管者監守自盜性質惡劣。在依紀依法追責問責的同時，鎮江市紀委監委派駐市衛健委紀檢監察組向該中心下發紀律檢查建議書，直指醫藥費報銷審批領導未設置AB角、未規定回避機制等制度漏洞。通過以案促改，推動市醫保局梳理業務流程、制度機制等方面25條廉政風險點，制定完善分級分類復核醫保報銷管理制度、審計獨立監督制度等3項制度，同時強化報銷稽核，按照不低于總量5%的比例隨機抽查復審。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">在鎮江市醫保服務大廳，記者翻閱多份報銷審核材料，現在最簡單的窗口報銷業務都要經過3人審核，而辦理10萬元以上的單筆費用至少需要6道審核，全程實名簽核、定期歸檔。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;"><strong>查找根源、齊抓共管，取得更大治理成效</strong></p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“很長一段時間，我們監督檢查室和派駐紀檢監察組的同志，天天在市醫保局、基層衛生站上班?！边B續兩年開展基層醫療機構專項治理，淮安市紀委監委第八監督檢查室主任朱紅娣說，最大的收獲是傾聽基層期盼、將問題解決好，并把好的做法融入日常監督。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“一線調研中，我們發現部分縣區醫保部門處罰自由裁量權過大，為追求監管效果動輒5倍頂格處罰，且部分地區職能部門問題線索處置效率較低，有的甚至幾個月無人處理?！狈从硢栴}直指監管、監督盲區。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">經多方溝通協商，淮安市紀委監委在市醫保監管平臺中嵌入“紀委監委監督”模塊，將醫?；鸨O管全程納入監督范圍。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">現在每一條醫保存疑問題線索暴露在“陽光”下，所有問題線索的詳情、處理進展在線展示、全程留痕、結果公開，醫保問題線索查沒查、怎么查，紀委監委可以隨時在線追溯、倒逼職能部門對違法違規行為一查到底。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">為何如此關注處罰公正？</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“對于一些經營不善的基層衛生院，一次處罰就能讓他們入不敷出?！苯衲?月，淮安開展基層衛生院突出問題專項巡察，巡察組組長江邁在走訪下轄全部衛生院、村衛生室、百余名群眾后感到，基層衛生院騙保問題之所以頻發，源自岌岌可危的發展營運狀況。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">受實際服務人口減少、上級大醫院虹吸等因素影響，淮安市大多數基層衛生院近年來業務萎縮、收入下降。加之人員經費水漲船高，部分基層衛生院運營困難，人才流失、設備老化等一系列問題隨之衍生。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“越是難以為繼就越倚重欺詐騙保這條‘捷徑’，越被監管部門處罰，越要靠套取醫?；鹛钛a漏洞，從而引發惡性循環?！苯~說。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">巡察組召集相關部門座談，進一步了解實際情況。一方面，基層衛生院按原有服務人口規模配置的人員、設備、病房等資源出現閑置；另一方面，市常住60周歲及以上人口數量超百萬，已進入“深度老齡化社會”，約12萬失能半失能老人迫切需要醫護服務。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">基于此，巡察組匯集各方意見，提出了醫養結合的建議：通過機構轉型、合作共建等多種形式發展醫養結合，為失能、半失能老人提供養生保健、康復治療等服務，既解決基層衛生院發展困境，又為日益嚴峻的養老問題紓困。建議專題報告提交后，經市委領導批示推動落實，目前，部分基層衛生院已逐步推進醫養結合試點。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">江蘇省紀委監委在推動專項整治過程中發現，要根治醫保詐騙問題，醫?；饟芨吨贫缺仨毜玫絻灮?。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">在欺詐騙取醫?；饐栴}專項整治持續向縱深推進之際，江蘇省醫保局于11月2日制發了醫療保障局關于規范醫療保障基金總額管理的實施意見，從省級層面對醫?；鹂傤~管理作出規范，要求各地明確統一的編制規則和程序，綜合考慮經濟增長、人口分布和流動、疾病譜變化、持續發展等多元復合式因素，科學測算制定設區市總額預算方案。同時建立醫療機構集體協商、醫保部門與醫療機構之間協商談判機制，促進定點醫療機構共同參與、公平競爭。</p><p style="padding: 0px; text-indent: 2em; margin-top: 0px; margin-bottom: 0px; min-height: 1em; box-sizing: border-box; user-select: text; -webkit-tap-highlight-color: transparent; -webkit-user-drag: none;">“隨著專項整治的深入，醫保制度的籠子越扎越緊，群眾看病就醫的滿意度不斷提升?！苯K省紀委監委有關負責人表示，下一步我們還將繼續督促醫保部門加強監管，推進醫?；鹁毣芾?，推動醫保高質量發展，解決人民群眾看病就醫的后顧之憂，共享醫保改革成果。（<span style="text-align: justify; color: rgb(62, 62, 62); background-color: rgb(255, 255, 255);">張琪彬</span>）</p><meta name="ContentEnd"><br/></div><div style="display:none"><script language='javascript' src="/module/visitcount/articlehits.jsp?colid=4794&artid=150557" > </script></div> <style> #mediaContent0_0{margin:0 auto;} </style> <script type="text/javascript"> $(function(){ var _html=$("#c-conten-con").html(); var videos=$("#videos").html(); var _vHtml=''; if(_html.indexOf("flv")<0 && _html.indexOf("mp4")<0){ if(videos.indexOf("flv")>=0){ _vHtml='<div id="mediaContent0_0" style="text-align: center;"><embed name="media_placeholder" id="mediaContent0" src="/module/jslib/ckplayer/ckplayer.swf" flashvars="f='+videos+'&p=0" allowscriptaccess="always" allowfullscreen="true" quality="autohigh" 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