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Chinese Journal of Health Policy ; (12): 28-34, 2017.
Article Dans Chinois | WPRIM | ID: wpr-668637

Résumé

With the rapid development of China's social insurance,the phenomenon of medical insurance fraud is also increasing,which seriously threatens the comprehensive operation of health insurance funds and medical insur-ance system. Because of the cooperation between the government and the market,Europe & US have accumulated a lot of experience and achieved considerable success in anti-medical fraud as the"harder-hit area"in insurance fraud. This paper discusses the anti-fraud mechanism of foreign medical insurance to establish medical anti-fraud agencies within the government,and give full play to the complementary role of non-profit organizations to strengthen the con-trol and supervision of medical insurance and health care institutions and uses modern information technology to im-prove anti-fraud level.

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