海南省醫(yī)保局曝光1起違法違規(guī)使用醫(yī)?；鸬湫桶咐?/title> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <meta http-equiv="X-UA-Compatible" content="IE=edge,Chrome=1" /> <meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1, user-scalable=no">  <meta name="SiteName" content="宜興市人民政府"> <meta name="SiteDomain" content="http://www.gdjd168.cn"> <meta name="SiteIDCode" content="3202820041"> <meta name="ColumnName" content="打擊欺詐騙保專欄"> <meta name="ColumnDescription" content=""> <meta name="ColumnKeywords" content=""> <meta name="ColumnType" content="打擊欺詐騙保專欄">  <meta name="ArticleTitle" content="海南省醫(yī)保局曝光1起違法違規(guī)使用醫(yī)?；鸬湫桶咐?> <meta name="PubDate" content="2025-04-13 16:23"> <meta name="ContentSource" content="市醫(yī)療保障局"> <meta name="Author" content="yxylbzj"> <meta name="Url" content="/doc/2025/04/13/1260830.shtml"> <script type="text/javascript" src="/zgyx/js/jquery-1.11.2.min.js"></script> <script type="text/javascript" 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Player.fn._open_url(a) : openWin(a, null, null, true) }; </script> <style> </style>  <div id="6ivda0r" class="header"> <div id="qch84vc" class="top"> <div id="5wlikiy" class="top_box"> <div id="fsotoys" class="log_reg_enter fr"> <div id="apo4kb3" class="login_state"> <a href="javascript:void(0);" onclick="loginClick()">登錄</a> | <a href="#" id="wza2-enable">無障礙瀏覽</a> <i id="wza2-i">|</i> <a href="javascript:void(0)" class="older_mode">長者模式</a> </div> <div id="0hflpig" class="login_after hide"> <span></span> <a href="/zgyx/grzx/index.shtml" target="_blank">個人中心</a> | <a id="alogout" href="javascript:loginOut();">退出</a> | <a href="#" id="wza2-enable" class="wza_dl_old">無障礙瀏覽</a> <i id="wza2-i-dl">|</i> <a href="javascript:void(0)" class="older_mode">長者模式</a> </div> </div> <p class="clearfix"></p> </div> </div> <div id="h8c30gf" class="top2"> <div id="bj9eusz" class="web_logo"> <img src="/yxwww/images/web_logo_zz.png" alt=""/> </div> </div> </div>  <div id="baimcae" class="siteName1"><a style="color:#d41e0b;font-size:24px;" href="/ylbzj/index.shtml" ><h1>市醫(yī)療保障局</h1></a></div> <div id="id0oa4w" class="row"> <div id="nlwuhom" class="bmNar"> <a class="nar_l" href="/ylbzj/index.shtml">網(wǎng)站首頁</a> <a class="nar_l" href="http://www.gdjd168.cn/ylbzj/zfxxgk/xxgkzn/index.shtml">政府信息公開</a> <a class="nar_l" href="/zgyx/hdjl/index.shtml">互動交流</a>  </div> </div>  <div id="lzgrhom" class="row" style="background-color: #fff;">   <div id="wvls44w" class="listbor_title"> <div id="ub4sndb" class="letter_adr"> <img class="letterimg_tit" src="/yxwww/images/home_locate.png"> 市醫(yī)療保障局>專題專欄>打擊欺詐騙保專欄 </div> </div>    <div style="margin: 0 auto;float:left;width: 1024px; "> <div id="niqx9fs" class="g_show_title"><span>海南省醫(yī)保局曝光1起違法違規(guī)使用醫(yī)?；鸬湫桶咐?/span></div> <div id="tl49433" class="g_show_rq" style="text-align: center;"> <span>來源：市醫(yī)療保障局</span> <span>時間：2025-04-13 16:23:23</span> <span>瀏覽次數(shù)： <span id="clickCount"></span></span> <script language="javascript"> $.ajax({ type:"post", url:"/intertidwebapp/counter/count", data:{ 'contentID':1260830, 'siteName':'宜興市人民政府', 'siteID':2 }, success:function(data){ $('#clickCount').html(data); }, error: function(XMLHttpRequest, textStatus, errorThrown) { } }); </script> <span>字號：[ <a href="javascript:void(0);" onclick="fontsizeL();">大</a> <a onclick="fontsizeN();" href="javascript:void(0);">中</a> <a onclick="fontsizeS();" href="javascript:void(0);">小</a> ]</span> </div> <div id="pwd3imt" class="g_show_article" id="_content"><span style="font-size: inherit;"> <p>　　今年以來，各級醫(yī)保部門加強醫(yī)?；鸨O(jiān)管力度，嚴厲打擊各類欺詐騙保行為，曝光了一系列違法違規(guī)使用醫(yī)保基金典型案例。以下是海南省醫(yī)保局曝光的典型案例。</p> <p>　　海南省婦女兒童醫(yī)學中心違規(guī)使用醫(yī)保基金被處罰</p> <p>　　海南省醫(yī)療保障局根據(jù)群眾舉報線索，于2024年3月對海南省婦女兒童醫(yī)學中心（以下稱該中心）涉嫌違法違規(guī)使用醫(yī)?；饐栴}予以立案調(diào)查。經(jīng)查實，該中心在2022年1月1日至2023年7月31日醫(yī)保結(jié)算周期內(nèi)開展診療過程中存在過度檢查、串換收費、重復收費、耗材超標準收費、耗材溢庫、藥品溢庫和其他違法行為（無資質(zhì)開展精神科項目收費）等多項違規(guī)行為，且上述行為均為連續(xù)狀態(tài)，涉及違規(guī)金額4569373.06元。依據(jù)《中華人民共和國行政處罰法》《醫(yī)療保障基金使用監(jiān)督管理條例》《海南省醫(yī)療保障基金使用監(jiān)督管理行政處罰自由裁量權(quán)適用規(guī)則》《海南省基本醫(yī)療保險、工傷保險定點醫(yī)療機構(gòu)服務(wù)協(xié)議》等相關(guān)規(guī)定，海南省醫(yī)療保障局對該中心存在的違規(guī)行為依法依規(guī)作出處理：1. 追回該中心違規(guī)金額4569373.06元，并對該中心違規(guī)使用醫(yī)保基金1700718.68元處1倍罰款。２. 約談該中心主要領(lǐng)導、分管領(lǐng)導和醫(yī)?？曝撠熑?，責令該中心對專案核查確定的違規(guī)問題限期整改。截至目前，已全部追回違規(guī)金額4569373.06元，行政罰款1700718.68元已全部上繳。</p> </span></div> <link rel="stylesheet" type="text/css" href="/yxwww/css/shareStyle.css" /> <div id="wutahml" class="shareDiv">  <style type="text/css"> #bdshare ul,#bdshare_s ul,#bdshare ul li,#bdshare_s ul li,#bdshare_l_c ul li,#bdshare_m_c ul li,#bdshare_pop ul,#bdshare_pop ul li { list-style:none; margin:0; padding:0 } 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