The consequences of fraudulently using someone else's medical insurance card

The medical insurance card is the medical certificate of the insured and the settlement certificate of medical expenses. Fraudulent use of other people's medical insurance cards will not only lead to the loss of medical insurance funds, but also interfere with the normal medical treatment of insured persons and damage their interests. The Measures for the Supervision of Medical Insurance clearly stipulates that it is illegal to fraudulently use other people's medical insurance certificates, and they should be ordered to refund the relevant medical insurance fees, and may be punished with a warning or a fine ranging from 100 yuan to 2,000 yuan. If the circumstances are serious, a fine ranging from 2000 yuan to 1 10,000 yuan may be imposed, and the accounting settlement method may be changed 1 to 6 months.

Everyone who participates in medical insurance has a medical insurance card. Users can use the medical insurance card to see a doctor, buy medicine or reimburse medical expenses. It has many functions, but it should be noted that the medical insurance card can only be used by itself, so what happens if you lend it to others? Let's look at the analysis together.

1, insurance fraud, against the law. However, from a legal point of view, fraudulent use of other people's medical insurance cards to reimburse medical expenses is already fraudulent insurance and should be investigated for legal responsibility. Even if the holder of the medical insurance card agrees to use it by others, reimbursement is not allowed.

2. People who fraudulently use medical insurance cards will be punished, and those who borrow medical insurance cards will also be implicated. According to this situation, many people may just do bad things with good intentions and have never thought about implementing bad behaviors such as fraudulent insurance. But if things do happen, both sides can't get away with it.

3. After borrowing someone else's medical insurance card, his medical record will exist in the file of the medical insurance card user, and this medical record will become his own, which will probably lead to the doctor's misdiagnosis of himself in the future.

According to China's Social Insurance Law, Regulations on the Supervision and Administration of the Use of Medical Insurance Funds, Criminal Law and other laws and regulations, the insured shall not take advantage of the opportunity to enjoy medical insurance benefits to resell drugs, accept cash, return in kind or obtain other illegal benefits. If the insured has the above-mentioned behavior, the administrative department of medical security may suspend the online settlement of medical expenses for 3 months to 12 months; For the purpose of defrauding the medical security fund, if the above acts are carried out, resulting in the loss of the medical security fund, the administrative department of medical security shall impose a fine of more than 2 times and less than 5 times the amount defrauded; Those who reach a large amount and violate the criminal law shall be investigated for criminal responsibility for fraud.

legal ground

People's Republic of China (PRC) social insurance law

Article 88 Anyone who defrauds social insurance benefits by fraud, forgery of certification materials or other means shall be ordered by the social insurance administrative department to return the defrauded social insurance benefits, and shall be fined at least two times but not more than five times the amount defrauded.