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<script>/*jQuery('#hh').width(jQuery('#a').width());*/</script> <div id="i2i2jyu4k" class="Remark"> <span>2014年11月22日 13:06 | 来源：<a target="_blank">《瞭望》新闻周刊</a></span> <span id="i2i2jyu4k" class="fr">  <div id="i2i2jyu4k" class="bdsharebuttonbox"><a href="#" class="bds_more" data-cmd="more"></a><a href="#" class="bds_qzone" data-cmd="qzone" title="分享到QQ空间"></a><a href="#" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博"></a><a href="#" class="bds_tqq" data-cmd="tqq" title="分享到腾讯微博"></a><a href="#" class="bds_renren" data-cmd="renren" title="分享到人人网"></a><a href="#" class="bds_weixin" data-cmd="weixin" title="分享到微信"></a></div> <script>window._bd_share_config={"common":{"bdSnsKey":{},"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":"0","bdSize":"16"},"share":{}};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')).src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];</script>  </span><span id="i2i2jyu4k" class="fr">分享到：<img src="http://www.rmzxb.com.cn/images/fx.jpg" /> </span> </div> <div id="i2i2jyu4k" class="text_box"> <p align="center"> <p> 　　海南省委日前给予海南省卫生厅原党组书记、厅长白志勤，现任海南卫生和计划生育委员会主任韩英伟严肃通报批评。海南医疗卫生系统43名干部先后因贪腐被查处，办案人员查处一个院长带出一批老板，查处一个老板又带出一批医务人员，《瞭望》新闻周刊记者调研发现，医疗设备采购成医务人员收受商业回扣重灾区。</p> <p> 　　受访业内人士认为，系列贪腐案件暴露出医?；鸺喙芊αΑ⒁搅粕璞覆晒褐贫炔煌晟?、医院医德考评流于形式等医疗体制中的诸多深层次问题，迫切需要健全相关医疗监管制度，完善有效防腐机制。</p> <p> 　　套取医保金凸显监管漏洞</p> <p> 　　在海南纪检监察机关查处的部分医院套取医?；鸬陌讣?，上至院长、副院长，下至科室主任、主治医生、护士等人人参与其中，病人办理入院手续时只要标明“请假病人”，表明这类病人不用缴纳住院押金，也根本不用住院，只是医院套取医保金的幌子。</p> <p> 　　海南省安宁医院是一家主治精神病的专科医院，2009年至2012年底通过虚开医嘱、虚开检查项目、虚列住院病人2962人次，套取医保基金2414万元。一些伪造的病历材料，不仅出现多个雷同病历，甚至不同患者检查项目的化验单数据竟然完全相同。</p> <p> 　　“科室实有86张病床，而登记的住院病人最高达到225人，是病床数的2.6倍。”海南省安宁医院临床四科医生许勤伟说，医院利用8个科室1800多名参?；颊叩淖柿?，虚开诊疗处方，伪造住院病历，虚构诊疗费向社?；股昵氡ㄏ?。</p> <p> 　　据办案人员介绍，海南省安宁医院的做法成为医疗行业内“公开秘密”后，一些经济效益偏差的医院也千方百计仿效增加收入。例如，东方市八所港区卫生院套取医保资金83万余元；中建农场医院套取医保资金47万余元。</p> <p> 　　《瞭望》新闻周刊记者采访发现，一方面，“以药补医”的医疗补偿机制不尽合理。医院纯劳务收入所占比例较小，而财政拨款又严重不足，海南一些条件较好的医院每年财政拨款不足其一个月的开支，医院主要依靠药品销售来补偿劳务收入的不足，海南各大医院药品收入占收入比例40%以上。因此，一些病人偏少的专科医院、乡镇和农场医院经营压力很大，通过骗保的方式为医院创收。</p> <p> 　　另一方面，原有的医保管理方式不能满足医?；鸾崴愫图喙艿男枰?。据本刊记者了解，海南医保信息管理系统功能单一，只有报账功能，没有监控和拦截警示，医保稽查主要依靠现场检查、票据核查等较为粗放的方式。?？谑屑觳煸旱陌彀溉嗽彼?，编造病历、开处方、治疗等多个环节，医院人员联手做手脚，监管部门短期内很难发现。虽然也有部分医院的工作人员对套取医保资金提出过质疑，但在医院院长带头违规违法时，单位监督机制形同虚设。</p> <p> 　　中国社科院经济研究所公共政策研究中心主任朱恒鹏说，医保监管需要通过信息技术手段进行精细化审核，更重要的是，要对医疗数据信息进行研发分析，尽快转型为专业性医保经办机构，依托智能化的“医?；鹬悄芄芾砥教?rdquo;遏制骗保、欺诈等乱象。</p> <p> </p> </div> <p class="Editor">编辑：罗韦 </p> <div id="i2i2jyu4k" class="Paging"> <a href="/c/2014-11-22/410021.shtml" class="a">01</a> <a href="/c/2014-11-22/410021_1.shtml">02</a> <a href="/c/2014-11-22/410021_2.shtml">03</a>  </div> <p class="Keyword">关键词：医保医院海南监管</p> <h1 class="pv_title_2 mt_15"><a target="_blank" class="more mtb_14">更多</a><span id="i2i2jyu4k" class="t" id="a3"><a ><img src="http://www.rmzxb.com.cn/images/xg_t1.jpg" /></a></span></h1> <div id="i2i2jyu4k" 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