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医院领导下令开-阴阳-处方 4年骗取医保基金898万

医院领导下令开"阴阳"处方 4年骗取医保基金898万
(原标题:“阴阳”处方骗取医保基金898万 长沙雨花:以诈骗罪批捕某民营医院两名负责人)

正义网讯 通过虚开药品、制作假病历等方法增加病人消费金额,然后到医保中心报取医疗保险基金,用这些所谓的“潜规则”骗取国家医保基金898万余元。近日,湖南省长沙市雨花区检察院以涉嫌诈骗罪批准逮捕了犯罪嫌疑人林华耀和林华雄。据悉,该案是湖南省首例诈骗国家医疗保险基金案。2011年3月,林华耀等5人共同出资在雨花区成立了长沙普济医院,主要治疗肾病、尿毒症等一些慢。当年10月保安服装订做,该医院与长沙市医疗保险服务中心签订长沙城区基本医疗保险定点医院医疗服务协议定做服装,成为长沙城区基本医疗保险和全省异地转诊参保患者的定点民营医院。2013年5月定做厨师服,林华耀开始担任该医院总经理,主持医院的全面工作。2014年初,林华雄担任该医院后勤部长,主要负责药品采购及医院方易系统和魅力潇湘系统的维护。2013年5月,林华耀为获取非法利益,组织召开医院中层干部会议制服装,要求临床医生针对具体病人制作两套处方订做工作服,一套处方用于报销医保,一套处方用于实际治疗衬衫订做。临床医生先制作一份符合报销的医保处方,录入对接医保局的方易系统工作服加工,这个处方不执行。然后医生再开一份执行处方棉服定制,这套处方录入到医院内部记录药品真实出入库情况的魅力潇湘系统西装。医保报销的处方用药量远远大于实际治疗处方用药。













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