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According to Dahe News report, on October 16, Ms. Huang, an employee of Xinhua Road Community Health Service Center in Xinzheng City, reported that the hospital fabricated fake cases to obtain national medical insurance funds, and said that after the report He was beaten by hospital leader Zheng and his eardrum was perforated. But Zheng said that the two parties only pushed and pushed each other and did not hit anyone. At present, Xinzheng Municipal Social Security Bureau and Medical Insurance Bureau have intervened in the investigation.
Whether the hospital fabricated false cases to cover, how Ms. Huang’s repeated reports were known to the leaders involved, whether Zheng had beaten Ms. Huang to have a perforated eardrum... These questions undoubtedly require local authorities to answer questions based on careful investigation. Explain clearly.
According to the reporter, Ms. Huang, the number of residents in the hospital during the National Day holiday was shown to be 42, but only 3 were actually hospitalized. The hospital adopted a method of "hanging beds" to obtain medical insurance funds of at least 100,000 yuan. Other colleagues also had opinions on this, but Don't dare to speak up. She also said that this happened more than once in the hospital. During major holidays such as National Day, May Day, and Spring Festival, when people at the medical insurance center were on vacation, the people involved would rush to falsify medical records.
Whether this is true or not still needs to be verified. If it is true, the relevant personnel of the hospital involved took great pains to hedging: they got the time right, and calculated that insiders in the hospital would not dare to come forward. However, they did not expect that there would be someone like Ms. Huang who dared to be tough. Whistleblower.
No matter what, medical insurance assets are public funds and life-saving money, and they cannot be eaten away by moths. At the end of last year, the National Medical Insurance Administration announced that it would launch a nationwide special campaign to crack down on fraudulent medical insurance, announced a national reporting hotline, and established a reporting reward system. In March this year, the National Medical Insurance Administration made it clear that it would launch a "people's war" against insurance fraud.
To combat fraud and hedging, we must make precise efforts: considering that hedging is a corruption phenomenon that occurs in the medical field and has the characteristics of insider participation, encourages insiders to come forward through incentives and protection measures, which is undoubtedly very Is necessary. "Internal whistleblowers" like Ms. Huang deserve encouragement and protection.
Looking at this incident, it is obviously necessary to improve the protection of whistleblowers. In this matter, whether the hospital leader Zheng merely pushed or beat Ms. Huang until her eardrum was perforated will certainly affect the severity but not the nature of the retaliation.
went further and said that even if there is no physical conflict, if the protection of the whistleblower is not done well, even if there is no visible "pushing", once the invisible "wearing of shoes" or "firing" occurs, it will cause The negative effect is that "those who work for everyone will be drowned in the wind and snow; those who report for everyone will be put in small shoes".
In addition, in view of the phenomenon of "hanging beds" during holidays reported by the reporters involved to defraud insurance, it is obviously necessary to come up with upgraded means of fighting monsters and all-weather keen antennae to crack down hard. After all, the most effective way to identify "bed hanging" is on-site inspection. Selecting "hanging bed" on holidays or even weekends is a loophole in supervision.
In view of this, it may be possible to use the power of technology to explore the power of intelligent product screening + manual review mode in the supervision of medical insurance funds, and compare and investigate abnormal situations.
To combat hospital “hedging”, we must protect “whistleblowers”. Only when pre-regulation and back-end protection for whistleblowers are put in place can the hedging chaos have nowhere to hide.
(Source: Beijing News Commentary WeChat Official Account)
