骗医保9844.19元！福清这个典型案例被曝光！
<section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; color: rgb(34, 34, 34); font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; text-align: center; line-height: 2em; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; letter-spacing: 2px; font-size: 18px; visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(217, 33, 66); visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">曝光！</span></strong></span></section><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; text-align: center; line-height: 2em; visibility: visible;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"/></section><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">近日，省医保局曝光</span></p><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">福建省13例欺诈骗保案例<br style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"/></span></p><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(0, 122, 170); visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">福州共有</span></strong></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(123, 12, 0); visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; font-size: 16px; letter-spacing: 2px; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;">3例</span></strong></span></p><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(0, 122, 170); visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">其中</span></strong></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(123, 12, 0); visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">1例</span></strong></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(0, 122, 170); visibility: visible;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">发生在福清</span></strong></span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;"></span></p><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">详情如下</span></p><section data-tools="135编辑器" data-id="100218" style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><section style="margin: 10px auto; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; width: 45px; transform: rotate(180deg); visibility: visible;"></section></section><section data-role="paragraph" style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"/></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; color: rgb(0, 0, 0); text-indent: 0em; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;"><strong style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;">福清市林某城隐瞒第三方责任骗取医保基金案</strong></span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; color: rgb(0, 0, 0); text-indent: 0em; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">2021年6月，福州市福清医保局在开展2021年打击欺诈骗保专项行动中，通过对外伤病人报销数据与交通事故报警记录进行核查比对，发现福清市城乡居民基本医疗保险参保人林某城涉嫌隐瞒第三方责任骗取医保基金。经查，2020年3月3日，林某城驾驶摩托车与薛某爱驾驶的摩托车发生相撞，造成林某城右肩部受伤，两辆摩托车不同程度受损。林某城与薛某爱达成口头调解协议，约定由薛某爱赔偿林某城医药费的60%，每月300元分期支付。2020年3月11日及4月23日，林某城两次就诊福清市医院，在申请医保报销时，其故意隐瞒第三方责任人，谎称自己骑车不慎摔伤，合计骗取医保基金9844.19元。</span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; color: rgb(0, 0, 0); text-indent: 0em; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px; visibility: visible;">依据《中华人民共和国社会保险法》，福清医保局将案件线索移交福清市公安局。2021年7月22日，林某城主动将骗取的医保报销款9844.19元退回到福州市医保中心福清管理部账户。鉴于林某城犯罪情节轻微，有自首情节且认罪认罚，2021年10月15日，福清市人民检察院对林某城作出不予起诉决定。</span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; color: rgb(0, 0, 0); text-indent: 0em; vertical-align: inherit; line-height: 2em; visibility: visible; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">依据《中华人民共和国社会保险法》《福州市医疗保障行政处罚裁量标准（〈中华人民共和国社会保险法〉部分）》等规定，2022年3月18日，福州市医保局对林某城处骗取基金金额9844.19元二倍的罚款计19688.38元。</span></p><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; box-sizing: border-box !important; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"/></p><section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; vertical-align: inherit; line-height: 2em; text-align: center;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">福州市仓山区和连江县</strong></span><strong style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; color: rgb(0, 0, 0); font-size: 16px; letter-spacing: 2px; box-sizing: border-box !important; overflow-wrap: break-word !important;"></strong></section><section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; vertical-align: inherit; line-height: 2em; text-align: center;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">也发生骗取医保基金的案例</strong></span></section><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; vertical-align: inherit; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">详情如下</span></p><section data-tools="135编辑器" data-id="100218" style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><section style="margin: 10px auto; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; width: 45px; transform: rotate(180deg);"></section></section><p style="margin-top: 0px; margin-bottom: 0em; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; box-sizing: border-box !important; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"/></p></section></section></section><p></p><section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); box-sizing: border-box !important; overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;"><strong style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">一、福州市仓山区赵某超量开药倒卖案</strong></span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">2021年6月，福州市医保局在开展打击欺诈骗保专项检查中，发现福州市城镇职工基本医疗保险参保人赵某等9人在多家基层医疗机构频繁就医并超量开具药品的线索。经查，赵某为谋取非法利益，与办有特殊病种的陈某娜、郭某检、郑某武、陈某英、王某江、刘某珍、林某明、商某蓉等8名城镇职工基本医疗保险参保人商量，利用特殊病种购买药品有高额补贴的医保政策，由赵某持上述人员医保卡至多家医疗机构超量开药再低价出售，所得赃款予以瓜分，共骗取医保基金313636.72元。2021年6月30日，福州市医保局将案件线索移交公安机关。</span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">依据《中华人民共和国刑法》，2021年11月19日，福州市仓山区人民法院作出判决，赵某犯诈骗罪，判处有期徒刑六年，并处罚金二万元人民币；责令赵某退出违法所得，返还给国家医保统筹基金账户。依据《中华人民共和国社会保险法》《福州市医疗保障行政处罚裁量标准（〈中华人民共和国社会保险法〉部分）》等规定，福州市医保局对陈某娜、郭某检、郑某武、陈某英、王某江、刘某珍、林某明、商某蓉等8人予以立案调查。</span></p></section><section style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; font-size: 17px; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); box-sizing: border-box !important; overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;"><strong style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">二、福州市连江县兰某文隐瞒工伤骗取医保基金案</strong></span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">2021年5月25日，福州市医保中心连江管理部收到群众举报，反映连江县城乡居民基本医疗保险参保人兰某文涉嫌虚假陈述外伤事实骗取医保基金。经查，2019年7月23日，兰某文在工地架上进行楼梯施工作业过程中因操作不慎从高处跌落受伤。在申请医保报销时，兰某文隐瞒工伤事实，谎编受伤原因为：“在家焊梯子时不小心从两米多高摔下来，与工伤无关”。2019年7月23日至2020年7月3日期间，兰某文因外伤多次进行门诊、住院治疗，共享受医保基金报销23968.14元。</span></p><p style="margin-top: 0px; margin-bottom: 15px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; vertical-align: inherit; text-indent: 0em; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px 0px 0em; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; letter-spacing: 2px;">依据《中华人民共和国社会保险法》，福州市连江医保局将案件移送连江县公安局刑侦大队，并追回全部医保基金23968.14元。</span></p></section><p></p><p><br/></p><p><span style="color: rgb(136, 136, 136); font-family: 宋体; font-size: 14px; letter-spacing: 0.54px; background-color: rgb(255, 255, 255);">来源 福建医疗保障 福州日报 </span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(136, 136, 136); font-family: 宋体; font-size: 14px; letter-spacing: 0.54px; background-color: rgb(255, 255, 255); box-sizing: border-box !important; overflow-wrap: break-word !important;">福</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(136, 136, 136); font-family: 宋体; font-size: 14px; letter-spacing: 0.54px; background-color: rgb(255, 255, 255); box-sizing: border-box !important; overflow-wrap: break-word !important;">州</span><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; color: rgb(136, 136, 136); font-family: 宋体; font-size: 14px; letter-spacing: 0.54px; background-color: rgb(255, 255, 255); box-sizing: border-box !important; overflow-wrap: break-word !important;">晚报</span></p><link rel="stylesheet" href="//www.fqlook.cn/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_hKM" id="wcn_editor_css"/> 得不偿失啊 别动这种歪脑筋了 这是什么操作 好好上班不好吗 现在医院开药都有限制，不知道他怎么做到的 医保的红线不能去碰 大家都要按规定来 现在怎么什么类型的咋骗份子都有啊 可恶的咋骗份子。
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