It causes dispute to refuse to pay the fixed hospitalization cost in medical insurance

It causes dispute to refuse to pay the fixed hospitalization cost in medical insurance
It is reported
(The intersection of reporter and Liu The rainbow would rather know slowly) Recently, the professional committee of association's medical legal system of Chinese hospital held in Guangzhou is at the academic annual meeting on the second, refusing to pay the fixed hospitalization cost question in medical insurance initiates and discusses warmly. Keeping and paying attention to organization and Chinese hospital association in medicine shows 3 investigations of coming from different channels respectively, the data investigated are inconsistent.
"It is the misinformation that ' the card hospital of medical insurance pursues the surplus '. " Human resources and relevant persons in charge of administrative center of social security department social insurance affairs say. She has offered the investigation in the national the 2620 Overall Planning area of a department of the social insurance: From July of 2008 to June of 2009, have not paid the expenses of more than 2,380 million yuan in national medical insurance caused by various reasons, only accounts for about 0.5% of the pool fund expenditure of the medical insurance. She think the data prove to it refuses to pay whom rate has in the legend to be high medical insurance. The ones that especially settled account and paid after examining at end were withheld in advance, is far smaller than 10% of the proportions that the government stipulates.
The investigation reveal, that medical insurance refuse to pay reason respectively for ultra quota, register for bed decompose, exchange medicines, forge document, act as fraudulent substitute for a person and other violation, among them take it than the biggest one is " Other violation " ,Including being violate norm of using medicine, check, use special material, medical document and come in and go out institute to be standard unstandard, etc excessively. Another group of data that this person in charge offered reveals, the stability income which the hospital obtains from the medical insurance is increasing too, took expenditure of urban basic medical insurance as examples, it was only 6,900 million yuan in 1999, it will be 208,400 million yuan in 2008.
A part of the association of Chinese hospital " The investigation of the question of refusing payment of medical insurance expenses of the hospital " Think, it is more general phenomenon to refuse to pay the expenses in medical insurance. This survey of 375 above- second -class hospitals in the whole country reveals, there are 9 to refuse to pay hospitals over 10 million yuan in urban worker's medical insurance, 5 million have 13 family 10 million, 1 million have 125 family 5 million, 100,000 have 117 house 500,000 yuan, 0~10 ten thousand yuan has 124, 7 hospitals have not refused payment.
Another investigation regarding the public hospital owes fee situation of the association of Chinese hospital reveals, 21% that the hospital of the western region owes in the fee in 2007 have not paid the expenses for the medical insurance.
Have expert think data first might relate to statistics requirements or financial account keeping of hospital way. Because in reality, if a hospital is refused payment over 10 million yuan by medical insurance, then this hospital is certain the medical insurance " Suspended " Treatment.
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