医保基金欺诈骗保现状及防范对策探析——以372份裁判文书为分析样本
作者:
作者单位:

作者简介:

胡九英(1996—),女,安徽安庆人,硕士研究生在读,研究方向为医院管理与健康管理;

通讯作者:

中图分类号:

C913.7

基金项目:

安徽高校人文社会科学研究重点项目“数字经济时代数字技能对女性创业的影响机制研究”(SK2020A0142);安徽省哲学社会科学规划青年项目“数字经济背景下安徽女性创业障碍解析与赋能路径研究”(AHSKQ2020D21)


Research on the current situation and countermeasures of medical insurance fund fraud ——Use 372 judgment documents as analysis samples
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    医保基金关乎民生,欺诈骗保行为严重损害人民的切身利益。文章对“中国裁判文书网”2011—2021年372份医保基金欺诈骗保案件文书进行深入分析,基于真实可靠的案件内容,发现医保基金欺诈骗保行为具有主体多元化、手段复杂化、行为隐蔽化的典型特征。同时,基于犯罪预防理论和当前中国犯罪预防体系的基本框架,提出深化制度改革、构建监管系统、优化市场秩序、提高犯罪成本、健全法治和道德教育等防范对策,进而构建起全方位、多层次、全员参与的医保基金欺诈骗保行为预防体系,为我国医保基金安全使用和健康治理提供科学决策参考。

    Abstract:

    The medical insurance fund is closely related to people’s livelihood,and its fraudulent behavior will seriously damage people’s vital interests. In this paper,based on the 372 documents of medical insurance fund fraud cases through“China judgment online”from early 2011 to late 2021,it reveals the typical characteristics of fraudulent medical insurance fund behavior are diversified subjects,complex means and behavior concealment. Additionally,based on the theoretical ideas related to crime prevention and the basic framework of the current crime prevention system in China,the paper puts forward several countermeasures by deepening institutional reform,building a regulatory system,optimizing market order,raising the cost of crime,and improving the rule of law and moral education,aiming to build up an all?round,multi?level and all? participant system for preventing fraudulent and deceptive behavior of medical insurance funds,and to provide scientific decision?making references for the safe usage and healthy management of the medical insurance fund.

    参考文献
    相似文献
    引证文献
引用本文

胡九英,吴娟,宋月丽,周毅,丁昱.医保基金欺诈骗保现状及防范对策探析——以372份裁判文书为分析样本[J].南京医科大学学报(社会科学版),2022,22(4):363~368

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:
  • 最后修改日期:
  • 录用日期:
  • 在线发布日期: 2022-09-01
  • 出版日期: