浅析民营医院医保基金监管问题与对策

Analysis of Problems and Countermeasures in Private Hospital Medical Insurance Fund Supervision

民营医院是我国医疗卫生事业的重要补充力量,对缓解群众“看病就医难”问题发挥了一定作用,但是部分民营医院在医疗服务过程中不能严格执行医保相关政策规定,欺诈骗保违规违法行为频发,给医保基金监管工作提出了新的挑战。本文以安徽省枞阳县为例,分析民营医院医保基金监管现状及存在的问题,并提出对策和建议,为进一步完善医保基金监管体系建设提供借鉴。

Private hospitals are an important complementary force to China's healthcare undertakings,and have played a role in alleviating the problem of people's"difficulty in getting medical treatment".However,some private hospitals are unable to strictly implement the relevant policies and regulations of medical insurance during the medical service process,thus medical fraud and violations occur frequently,posing new challenges to the supervision of medical insurance funds.This paper takes Zongyang County of Anhui Province as an example,analyzes the current situation and problems in private hospital medical insurance fund supervision,and puts forward countermeasures and suggestions to further improve the construction of the medical insurance fund supervision system.