Xinjiang Exposes Multiple Cases of Illegal Use of Medical Insurance Funds

The Xinjiang Medical Security Bureau recently exposed five cases of illegal use of medical insurance funds, involving multiple medical institutions in Urumqi. These institutions are suspected of inducing insured individuals to be hospitalized for fraudulent insurance claims, fabricating medical services, and excessive medical examinations.

Urumqi Youhao Traditional Chinese Medicine Hospital: Suspected of inducing insured individuals to be hospitalized without medical indication, falsely uploading charges, and excessive medical treatment. The medical insurance department recovered 208,115.11 yuan in illegal funds and suspended its medical insurance service agreement.

Urumqi Pharmaceutical Group Affiliated Hospital: Fabricated medical services and examination items, excessive examinations, and fragmented charges. The medical insurance department suspended its medical insurance service agreement.

Urumqi High-tech Zone Fan Shuxin Traditional Chinese Medicine Clinic: Charged for substituted medical services, chaotic management, and refused medical insurance inspections. The medical insurance department suspended its medical insurance service agreement.

Urumqi Tianshan District Nanwan Sub-district Committee North Nanwan Street Community Health Service Station: Charged for substituted medical services, unqualified personnel practicing without a license. The medical insurance department recovered 1,419,825.54 yuan in illegal funds and suspended its medical insurance service agreement.

Shayibake District Yashan Sub-district Committee Nanliangpo Community Health Service Station: Forged medical documents, charged for self-paid items, and overcharged. The medical insurance department recovered 480,803.87 yuan in illegal funds and suspended its medical insurance service agreement.

These cases reveal loopholes in the management of medical insurance funds and the illegal activities of medical institutions. The medical insurance department needs to strengthen supervision to ensure the safety of funds and protect the rights of insured individuals.