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南宁:发现这些医保欺诈行为请举报 最高可奖励10万

时间:2019-08-14 00:46 点击:
南宁:发现这些医保欺诈行为请举报 最高可奖励10万,近日,市医保局、财政局结合本市工作实际,联合印发《关于转发〈广西欺诈骗取医疗保障基金行为举报奖励暂行办

  南宁日报讯(记者莫岚远 实习生苏小倩)近日,市医保局、财政局结合本市工作实际,联合印发《关于转发〈广西欺诈骗取医疗保障基金行为举报奖励暂行办法实施细则(试行)〉的通知》(以下简称《通知》),设立了举报奖励资金,鼓励举报欺诈骗取医疗保障基金的行为,经查证属实的案例,举报人最高可获10万元奖励。

  《通知》明确了我市欺诈骗保举报奖励的标准和奖金发放程序等实施细则。其中,举报奖励标准分为四个等级,前三个等级奖励金额依据查实欺诈骗保金额、奖励档次等因素综合计算确定,按涉案金额2%—6%奖励。每起案件的奖励金额不超过10万元,不低于500元。第四个“其他”等级,虽然不涉及金额,但举报违法违规情况若属实,也可以获得300—500元的奖励。

  《通知》还明确,举报人为定点医疗机构、定点零售药店内部人员或原内部人员,或者定点医疗机构、定点零售药店竞争机构及其工作人员,并提供可靠线索的,经查实涉及金额的,可在相应档次的奖励额度上浮1%给予奖励;不涉及金额的,可在相应档次的奖励金额基础上增加200元奖励。

  如举报人举报的事项不属于我市医保部门职责范围的,受理举报的部门将告知举报人向有权处理的单位举报,或将举报材料及时移交有权处理单位。


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