Original title: what's the matter with gynecology department full of male patients? Why are all male patients in Heze gynecology hospital
The patients who get medical insurance reimbursement may not be all the patients who really need it, but also may be the swindlers of minor illness, false hospitalization and unruly hospitals. On the 23rd, Shandong Province's first provincial TV political program was broadcast live as scheduled, and the Provincial Medical Security Bureau accepted the political inquiry. In order to defraud medical insurance, male patients can also be admitted to gynecological hospitals. It is clear that there is a policy, but the medical insurance card can not be used in other places, and if the invoice is lost, it can not be reimbursed.
A male patient came to the gynecological hospital
If you pay, you'll have to pay
There is a gynecological hospital named Wanhe hospital in Mudan District of Heze City. The reporter found many unusual phenomena in the hospital. Although there were many patients in the hospital, they didn't seem to be accompanied. In a ward, the six patients in six beds all came by themselves, and they were all male patients. The patient told the reporter that no matter what kind of disease they are suffering from, they only need to pay 300 yuan of hospitalization expenses and 50 yuan of food expenses when they are hospitalized, and then they can be hospitalized and treated. However, if you want to stay in a hospital, there is a prerequisite that you can't live without medical insurance. In Heze Zhongda Charity Hospital, the reporter also found the phenomenon of suspected hospitalization insurance fraud.
In this regard, Zhang Ningbo, director of the Provincial Medical Security Bureau, said that from the situation in the video, if the situation is true, it is a typical false hospitalization, hanging bed hospitalization and serious treatment of minor diseases, which is a serious fraud. We must crack down on such problems and behaviors according to law.
How can't you find the designated hospital on the public address
Mr. Gao and his wife both hold Yantai employees' social security cards. They came to Jimo District of Qingdao five years ago and have lived there ever since. Mr. Gao said that over the years, he has been troubled by one thing, that is, Mingming's social security card has more than 10000 yuan, but it can't be used to buy medicine in Jimo district. According to the provincial medical insurance bureau, 920 hospitals and 497 pharmacies have been listed as the first batch of online hospitals to realize the card swiping of medical insurance personal accounts in different places in the province, including one designated pharmacy and several designated hospitals in Jimo District of Qingdao city.
This made Mr. Gao very happy. He came to the address on the list of designated drugstores that day, but he couldn't find the designated drugstore named Qingdao wanhetai Pharmaceutical Co., Ltd. Park Security told, here is mainly engaged in wholesale logistics, and pharmacy has no relationship.
In desperation, the reporter and Mr. Gao came to the people's Hospital of Jimo district on the list of medical institutions. 'This card can be used as a hospital clinic card, but it doesn't mean that your money can be used. 'the staff of Qingdao Jimo District People's Hospital replied. On the self-service machine in the outpatient Hall of this hospital, the staff helped Mr. Gao to operate it several times. However, no matter how to operate it, the screen showed 'the social security card does not exist'. In Jimo District Hospital of traditional Chinese medicine, Mr. Gao encountered the same problem -- Mr. Gao's social security card was certified invalid.
Zhang Ningbo, director of Shandong Medical Insurance Bureau, saw the exposure on the live broadcast of the program and said frankly that "we are sweating because we do not have our own information system at present. We will work with relevant departments to solve this problem. We want to solve the problem of people's credit card before June 10. "As for the problem that the drugstores on the list do not exist and the information is not displayed by swiping cards in other places, director Zhang Ningbo said," after the list was published, I visited the drugstores in Jinan, but I didn't find this problem. We asked the medical insurance center to report this work in the form of a notice. '
Can't the invoice be reimbursed if it's lost?
On July 23 last year, the former social insurance bureau of Shandong Province issued a handling opinion on the loss of invoices in the reimbursement of medical expenses. After the institutional reform, the business of the former social insurance bureau was merged and reorganized into the current provincial medical security bureau. So is the policy still effective? For this problem, Zhang Ningbo, director of the Provincial Medical Security Bureau, made it clear that the policy is still effective. However, some local medical security departments did not implement it.
Rizhao's Mr. Wang encountered such trouble. His father was admitted to Shanghai Dongfang Hepatobiliary Hospital because of liver cancer, and his medical invoice was accidentally lost when he was discharged for reimbursement. Although there is a policy that if the invoice is lost, it can be reimbursed according to the law after the hospital has issued a certificate, Mr. Wang is still told that he can not be reimbursed after he has completed the certificate. "If the invoice is lost, it is equivalent to losing money." even more than a month after the court ruled that the medical insurance institution should perform the reimbursement according to the law, Mr. Wang still failed to complete the reimbursement. Reporter investigation found that the same problem also appeared in Jining Jiaxiang and other places.
For this problem, Zhang Ningbo, director of the Provincial Medical Security Bureau, said that he was very angry with the problems reflected in the video. As director of medical insurance, he had the responsibility to apologize to Mr. Wang's father for such problems. He said that "we will send staff to Rizhao tomorrow" and work with local government departments to check the problem. If everything is true, we will deal with it immediately. At the same time, they will further rectify their work style in the provincial health insurance system, and will never allow similar things to happen again.