What behaviors belong to medical insurance fraud?

14 behavior of designated medical service institutions, designated drug business units, insured individuals and other personnel belongs to the behavior of defrauding medical insurance funds.

2. Allowing or inducing non-insured individuals to be hospitalized in the name of the insured.

(3) The medical expenses paid by the insured individuals at their own expense shall be reported to the medical insurance fund for payment.

4. Insured individuals who hang their beds in the hospital or can be treated in outpatient clinics will be admitted to the hospital.

5. Take repeated registration, repeated or no indication treatment, decomposition of hospitalization and other ways to provide transitional medical care or unnecessary medical services for insured individuals.

6. In violation of the scope of medical insurance drugs or drug varieties, excessive, repeated and illegal use of drugs with special restrictions, or dispensing drugs for insured individuals by decomposing or changing prescriptions.

(seven) the expenses incurred by non-designated medical institutions shall be included in the expenses of designated medical institutions and medical insurance agencies for settlement.

8. Assist the insured individual to withdraw the medical insurance personal account fund or overall fund.

9. Unauthorized raising of charging standards, increase of charging items, decomposition of charges, repeated charges, expansion of charges and other illegal charging behaviors.

10 fraudulently obtained medical insurance funds or personal account funds by means of false reporting and data transmission.

1 1 sells drugs for non-designated drug business units and swipes social security cards on their behalf.

12 Change the expenses of drugs, diagnosis and treatment items, medical materials, medical service facilities or daily necessities, health care products, etc. beyond the scope of medical insurance payment into expenses within the scope of medical insurance policy, apply for medical insurance settlement, and collect funds for payment.

13 forged or used false medical records, prescriptions, inspection and laboratory reports, disease diagnosis certificates and other medical documents to defraud the medical insurance fund.

14 used false medical bills for reimbursement.

15 other acts that violate the relevant provisions of social insurance and cause losses to the medical insurance fund.