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时间:2019-04-15 09:58:56  来源:  作者:
   4月11日至30日,我市组织开展“打击欺诈骗保维护基金安全”集中宣传月活动,强化定点医疗机构和参保人员法制意识,严打医保领域欺诈骗保行为,营造全社会关注并自觉维护医疗保障基金安全的良好氛围。
    活动期间,我市将面向全社会大力宣传医疗保障基金监管法律、法规及欺诈骗取医疗保障基金行为举报投诉渠道和举报奖励办法,鼓励社会监督,并选取欺诈骗保典型案件,向社会公布查处情况。
    成立巡回宣讲队,采取进街道社区、进乡镇农村、进医院药店等形式,解答群众疑问,提高相关政策公众知晓率。在乡镇(办)政府、村街、社区,通过海报、折页、条幅、宣传栏、情景短片、公益广告等群众喜闻乐见、通俗易懂的宣传形式,加强舆论引导和正面宣传。以医疗保障经办窗口、定点医疗机构门诊大厅、定点药店为主要场所,张贴宣传海报,发放宣传资料,播放宣传短片和宣传标语。同时,充分利用电视、广播、报纸、微信、网站等多种渠道,加强信息公开,构建良好舆论氛围。通过典型案例通报会等形式,曝光典型案例,提高公众对打击欺诈骗保的认知。
    进一步规范临床诊疗服务行为,严格控制过度医疗,加强医务人员对欺诈骗保行为的认定等相关知识培训,增强法律意识,提高医疗服务的质量和水平,杜绝骗保套保现象发生。医保、卫健、公安、市场监管等部门将重点对医院、药店、参保人员开展联合检查,严厉查处骗保案件。对二级及以上公立医疗机构,重点查处分解收费、超标准收费、重复收费、套用项目收费、不合理诊疗及其他违法违规行为。对基层医疗机构,重点查处挂床住院、串换药品、耗材和诊疗项目等行为。对民营医疗机构,重点查处诱导参保人员住院、虚构医疗服务、伪造医疗文书票据、挂床住院、盗刷社保卡等行为。对定点零售药店,重点查处聚敛盗刷社保卡、诱导参保人员购买化妆品、生活用品等行为。对参保人员,重点查处伪造虚假票据报销、冒名就医、使用社保卡套现或套取药品、耗材倒买倒卖等行为。记者张晓红、张玉凤
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