从骗保个案探讨医疗机构如何加强异地就医管理

摘要

Remote medical treatment is a long-standing social phenomenon. Strengthening the management of remote medical treatment and preventing insurance fraud behavior is not only the requirement of the national policy, but also an important daily work of medical institutions' insurance management department. Based on an insurance fraud case, this paper tries to analyze the case from three aspects, including motivation, incentives and legal liability, and introduces medical institutions'practice of remote medical treatment management. This paper also gives suggestions on improving the management, aiming to provide some enlight-enment and reference for related departments.%异地就医是一种长期存在的社会现象。加强异地就医管理、严防欺诈骗保行为不仅是国家的政策要求，也是医疗机构医保管理部门日常重点工作。该文从一起异地就医骗保个案入手，试图从骗保的动机、诱因和法律责任三个方面对案例进行分析，介绍了医疗机构加强异地就医管理的做法，并提出完善异地就医管理的建议，以期为相关部门提供一些启示和借鉴。