1. Insurance fraud case in Jinjing Hospital, Jinzhou City, Liaoning Province
After a joint investigation by Jinzhou Medical Insurance Bureau and Public Security Bureau, it was found that Huang Moumou, the president of Jinjing Hospital, and many people inside and outside the hospital used the medical insurance cards of employees, residents and students to swipe their cards in the medical insurance system of Jinjing Hospital to defraud the medical insurance fund of 290683. 15 yuan. All the illegal funds in this case were recovered and returned to the fund account of the medical insurance center.
After trial by the local court, the verdict is as follows: the defendant Huang Moumou, president of Jinjing Hospital, was convicted of fraud, sentenced to 8 years and 8 months in prison and fined 500,000 yuan; The defendant Tian Moumou, a legal person of Jinjing Hospital, was convicted of fraud, sentenced to 9 years in prison and fined 500,000 yuan; The defendant Xu Moumou, a doctor of Jinjing Hospital, was convicted of fraud, sentenced to 7 years and 3 months in prison and fined RMB300,000.
The defendant Duan Moumou, a financial officer of Jinjing Hospital, was convicted of fraud, sentenced to 5 years and 6 months in prison and fined RMB250,000. Defendant Yang Moumou, an employee of Jinzhou Jiutai Pharmaceutical Co., Ltd., was convicted of fraud, sentenced to 4 years' imprisonment and fined RMB 1.5 million; Defendant Han Moumou, a teacher of Liaoning Petrochemical Vocational and Technical College, was convicted of fraud, sentenced to three years in prison, suspended for three years and fined 50,000 yuan.
2. The insurance fraud case of Wangchengpo Wangchun Hospital in Changsha City, Hunan Province.
After investigation by Changsha Public Security Bureau and Medical Insurance Bureau, it was found out that Li Moumou, vice president, dean and legal person Liu Moumou of Wangchengpo Hospital in Changsha defrauded the medical insurance fund of RMB 4,253,947.38 in terms of drugs, laboratory tests and Chinese medicine package treatment. The criminal suspects Li Moumou and Zhu Moumou have returned the illegal income of RMB 2 million and RMB 65,438+10,000 to Changsha Medical Security Affairs Center respectively, and the remaining illegal funds of RMB 2153,947. 38 yuan has also returned to Changsha Medical Security Affairs Center.
After trial by the court, the verdict is as follows: Liu Moumou and Li Moumou defrauded the national medical insurance fund, and the amount was extremely huge. Their actions have constituted the crime of fraud. Sentenced Liu to fixed-term imprisonment of 10 year and fined 10 million yuan; Li was sentenced to 3 years in prison, suspended for 5 years, and fined 70,000 yuan.
3. Fraud and insurance fraud in Yikang Chinese Medicine Hospital of Heshuo Silk Road, Bayinguoleng Mongolian Autonomous Prefecture, Xinjiang Uygur Autonomous Region.
According to the clues, the Heshuo Medical Insurance Bureau of Bayinguoleng Mongolian Autonomous Prefecture conducted an investigation and found that Yang Moumou, a legal person of Yikang Chinese Medicine Hospital on the Silk Road in Heshuo, had forged medical records, lowered the standard hospitalization, falsely listed expenses, abused antibiotics and other illegal facts. And suspected of using medical insurance in violation of regulations, the amount is 10.44 million yuan. After the case was handed over to the public security, the person involved, Yang Moumou, was criminally detained by the public security for alleged fraud, and all the illegal income was recovered and returned to the fund account of the medical insurance center.
After trial by the local court, the verdict is as follows: the defendant, Yang Moumou, a legal person of Shuosi Yikang Chinese Medicine Hospital, was convicted of fraud, sentenced to three years in prison, suspended for five years, and fined RMB 654.38+10,000.
4. Zeng Moumou's fraud case in the National Medical Center of Qiliping Town Central Health Center, Hong 'an County, Huanggang City, Hubei Province.
Through a joint investigation by the Medical Insurance Bureau of Hong 'an County and the Public Security Bureau, it was found that Zeng Moumou, an employee of the National Medical Center (Rehabilitation Department) of Qiliping Town Central Health Center, defrauded the medical insurance fund by forging medical records from August/KLOC-0 to May 25, 2065438. The illegal funds obtained in this case were recovered and returned to the fund account of the medical insurance center.
After trial by the court, the defendant was convicted of fraud, and the amount of fraud was 264,927.12 yuan. He was sentenced to three years and six months in prison and fined 654.38 million yuan.
5. Corruption case of former medical insurance administrator and pharmacy toll collector in Liu Jiaying Township Health Center, Fengrun District, Tangshan City, Hebei Province.
According to the investigation by the Medical Insurance Bureau of Fengrun District, Tangshan City, Nian Moumou, the medical insurance administrator and pharmacy toll collector of Liu Jiaying Township Health Center, was suspected of defrauding the medical insurance fund by falsely reporting hospitalization information during 20 18. After the case was handed over to the public security, the public security department further investigated and fixed the relevant evidence, identified the above illegal facts, and recovered the illegal income of 44,884.65 yuan.
After trial by the local court, the verdict is as follows: The defendant was sentenced to seven months' imprisonment, suspended for one year, and fined RMB 65438+ 10,000 yuan for alleged corruption in.
6. The case of Li Moumou, a villager in Bakunzhong Village, Yikenzhong Township, Ningcheng County, Chifeng City, Inner Mongolia Autonomous Region.
According to the investigation of Ningcheng County Medical Insurance Bureau of Chifeng City, the insured Li Moumou used the medical insurance fund to reimburse the medical expenses of 38,964.66 yuan from 20 17 to 20 19 (the expenses should not be paid by the medical insurance fund), which was suspected of fraudulent insurance.
On April 2, 2020, the local court passed the judgment as follows: the defendant Li Moumou was convicted of fraud, sentenced to one year and six months in prison, suspended for two years, recovered the defendant Li Moumou's illegal income of 38,964.66 yuan, returned it to the fund account of the medical insurance center, and fined 5,000 yuan.
Seven, Lianyungang City, Jiangsu Province, Zhu Moumou fraud insurance fraud.
According to the investigation of Lianyungang Medical Insurance Bureau, Zhu Moumou, the daughter-in-law of the insured Bi Moumou, had the illegal fact that the co-doctor Jiang Moumou deliberately concealed the responsibility of the third party and used the medical insurance fund to reimburse the medical expenses of 22,859.82 yuan (the expenses should not be paid by the medical insurance fund) by forging the contents of the trauma approval form, which was suspected of fraudulent insurance. After the case was handed over to Haizhou Public Security Bureau of Lianyungang City, the above situation was verified to be true.
After trial by the local court, the verdict is as follows: the defendant Zhu Moumou was convicted of fraud, sentenced to six months in prison, suspended for one year, fined 20,000 yuan, and returned 22,859.82 yuan to the fund account of the medical insurance center.
Eight, Anhui Chuzhou Lai 'an insured Yang Moumou fraud insurance case.
According to the investigation by the Medical Insurance Bureau of Lai 'an County, Chuzhou City, the insured Yang deliberately forged three hospitalization invoices to prepare for medical insurance reimbursement, and was suspected of defrauding medical expenses of 1.55 million yuan. After the case is handed over to the public security, verify that the above situation is true.
After trial by the local court, the verdict is as follows: the defendant Yang Moumou was convicted of fraud (attempted), sentenced to three years in prison, suspended for three years, and fined 20,000 yuan.
9. The case of misappropriation of public funds by Yang Moumou of Pu 'er Medical Insurance Management Center in Yunnan Province.
The investigation by Pu 'er Medical Insurance Bureau found that Yang Moumou, the former chief of the Financial Statistics Department of Pu 'er Medical Insurance Center, was seriously suspected of misappropriating medical insurance funds. After the clues of the case were handed over to the Supervision Committee of the Pu 'er Municipal Commission for Discipline Inspection and the public security for further investigation, the evidence was locked, and all the illegally obtained funds were recovered and returned to the fund account of the medical insurance center.
After trial by the local court, the verdict is as follows: Yang Moumou, the former chief of the Financial Statistics Department of Pu 'er Medical Insurance Center, misappropriated public funds of RMB 947,836.89, which constituted the crime of misappropriation of public funds, and was sentenced to two years' imprisonment and suspended for two years.
Guangzhou Daily-National Medical Insurance Bureau exposed 9 cases of insurance fraud, involving several hospital presidents.