一个村2000多人“脑中风”，老人去世后仍有医保结算记录？当地通报
<di><section style='line-height: 1.5em;margin-bottom: 20px;' data-mpa-powered-by="yiban.io"><br></section><section data-source="bj.96weixin.com" style='outline: 0px; max-width: 100%; font-size: 16px; color: rgb(62, 62, 62); line-height: 25.6px; box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='margin-top: 10px; margin-bottom: 10px; outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='margin-top: -4px; padding: 10px; outline: 0px; max-width: 100%; background-color: rgb(239, 239, 239); box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><section style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><p style='margin-bottom: 5px; line-height: 2em;'><span style='font-size: 15px;'>近日，有群众反映称，在山东省菏泽市单县莱河镇崔口村，大多数村民名下的城乡居民医保账户，近五年来莫名出现多次脑中风的医保结算记录。<span style='font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;'>总台记者调查发现，有孩子刚刚5岁就有了脑中风的医保结算记录；有老人去世后仍有48次医保消费，究竟是谁在骗取医保资金？</span></span></p></section></section></section></section></section></section></section></section><section style='outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; margin-top: 20px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(0, 122, 170); box-sizing: border-box !important;'><strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 18px; box-sizing: border-box !important;'>医保账户被盗刷</span></strong></span></section><section style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(0, 122, 170); box-sizing: border-box !important;'><strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 18px; box-sizing: border-box !important;'>一村民多位家人<strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>被</span></strong>“脑中风”</span></strong></span></section><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>今年7月，山东菏泽单县莱河镇崔口村村民陈士勇在单县中心医院做了一个手术，出院后他到村卫生室继续输液治疗，却意外发现自己的城乡居民医保账户上没有钱。随后，他找到单县医疗保障局，查询发现，<strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>自己的医保账户竟然被多次盗用</strong>。</span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='font-size: 15px;'><span style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>根据陈士勇提供的医保结算清单，2016年2月至2019年12月，他有过16次脑中风的医保结算记录，</span><strong style='outline: 0px; max-width: 100%; font-size: 16px; box-sizing: border-box !important;'>医疗机构名称为崔口卫生室，经办机构名称为单县医保局</strong><span style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>。</span></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>陈士勇表示，自己没有脑中风病史，医保结算清单上的记录，他本人也毫不知情。这两年自己长期在外面打工，城乡医保始终没有用过，并且家人都参与城乡医保，都有各自的医保账号，家人不会用他的账号去买药。</span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>因为所谓“脑中风”医保记录，陈士勇此前投保的商业健康保险，也拒绝理赔，“投保有个先前告示，其中就有脑中风不能参与投保。”</span></p><p style='outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; text-align: center; box-sizing: border-box !important;'><span class="wxart_image" wx-style='display:inline-block;outline: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 394px !important;visibility: visible !important;'></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(136, 136, 136); box-sizing: border-box !important;'>△陈士勇因“脑中风”医保记录被保险公司拒赔</span></p><section style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>陈士勇通过查询还发现，他的妻子、二弟、三弟等家人，也都有所谓“脑中风”的医保结算记录，尤其是其二弟陈士庚已在外务工多年，从未在村卫生室看过病。</span></section><section style='outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(0, 122, 170); box-sizing: border-box !important;'><strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 18px; box-sizing: border-box !important;'>2000多名村民被“脑中风”</span></strong></span></section><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(0, 122, 170); box-sizing: border-box !important;'><strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 18px; box-sizing: border-box !important;'><strong style='letter-spacing: 0.544px; outline: 0px; max-width: 100%; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>37000多条医保结算记录存在问题</span></strong></span></strong></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>村里更多村民查询发现，自己在不知情的情况下，就得了所谓“脑中风” ，而且大多数都是在崔口村卫生室报销结算的，涉及村民竟达两千多人。</span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; letter-spacing: 0.544px;'>拿着一张张医保结算清单，村民陈雪侠告诉总台记者，她查询发现</span><strong style='outline: 0px; max-width: 100%; font-size: 16px; letter-spacing: 0.544px; box-sizing: border-box !important;'>全家9口人都有所谓“脑中风”的医保结算记录，其中包括当时只有5岁的孩子。</strong></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'><span style='letter-spacing: 0.544px; outline: 0px; max-width: 100%;'>更让人难以置信的是，有村民去世后还有医保消费。村民陈士印告诉总台记者，</span><strong style='letter-spacing: 0.544px; outline: 0px; max-width: 100%; font-size: 16px; box-sizing: border-box !important;'>他的母亲孙富梅今年3月就去世了，医保记录显示此后竟然还有48个医保结算记录。</strong></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='letter-spacing: 0.544px; outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>采访中，多位村民担心，“脑中风”的医保结算记录会影响正常的升学就业、参军、保险赔付等。</span></p><section style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span class="wxart_image" wx-style='display:inline-block;letter-spacing: 0.544px;text-align: center;outline: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 677px !important;visibility: visible !important;'></span><br></section><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='font-size: 15px;'><span style='letter-spacing: 0.544px;'>相关问题暴露后，据单县相关部门初步排查，</span><strong style='letter-spacing: 0.544px; font-size: 16px; outline: 0px; max-width: 100%; box-sizing: border-box !important;'>崔口村2000多名村民起码有37000多条医保结算记录存在问题</strong><span style='letter-spacing: 0.544px;'>。</span><strong style='letter-spacing: 0.544px; font-size: 16px; outline: 0px; max-width: 100%; box-sizing: border-box !important;'>而且不止这个村，类似情况在其他村庄也不同程度存在。</strong></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>采访中，单县医疗保障局相关负责人李鹏向总台记者证实，不仅仅是崔口村，莱河镇12个村卫生室，其中7个存在这样的情况，其他乡镇也不同程度存在类似现象。</span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='font-size: 15px;'><span style='letter-spacing: 0.544px;'>一个村庄出现这么多“脑中风”患者，医保部门为何未及时发现并纠正？李鹏称，</span><strong style='font-size: 16px; letter-spacing: 0.544px; outline: 0px; max-width: 100%; box-sizing: border-box !important;'>医保部门每月只审核乡镇卫生院上报的医保结算数据，不具体审核村级卫生室的相关数据。</strong></span></p><section style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'></strong></section><p style='margin-bottom: 5px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 16px; box-sizing: border-box !important;'><span class="wxart_image" wx-style='display:inline-block;outline: 0px;text-align: center;box-sizing: border-box !important;overflow-wrap: break-word !important;width: 677px !important;visibility: visible !important;'></span></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; color: rgb(136, 136, 136); box-sizing: border-box !important;'>△单县基层医疗卫生机构管理信息系统页面，只要输入村民姓名和身份证号，村医就可以开处方药物。</span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>针对此事，中国社科院健康业发展研究中心副主任陈秋霖分析说，<strong style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'>仅靠村医个人是无法操作这么大范围、这么重疾病骗保的</strong>。调查的关键在于，大量问题医保结算记录的背后，被套出的药和钱究竟流向了何方？“在这个过程当中，村医有没有拿到钱，处方开出去以后，这个药是谁给的？”</span></p><section style='margin-bottom: 20px;'><span style='color: rgb(0, 122, 170);'><strong><span style='font-size: 18px;'>当地通报：有关村卫生室医保报销资格撤销</span></strong></span></section><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='font-size: 15px;'><span style='letter-spacing: 0.544px;'>据“单县发布”微信公众号消息，经调查核实，<strong>群众疾病名称在村级卫生室医疗结算系统中登记的错误信息已纠正</strong>，并向群众进行了解释说明。根据初步调查结果，</span><strong style='font-size: 16px;letter-spacing: 0.544px;'>县卫健局对当事人作出了“暂扣乡村医生执业证书”的处理决定，县医保局责成乡镇卫生院暂停了莱河镇有关村卫生室医保报销资格</strong><span style='letter-spacing: 0.544px;'>。</span></span></p><p style='margin-bottom: 20px; outline: 0px; max-width: 100%; font-family: -apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; line-height: 2em; box-sizing: border-box !important;'><span style='outline: 0px; max-width: 100%; font-size: 15px; box-sizing: border-box !important;'>针对村医涉嫌盗刷居民医疗保险门诊统筹金的问题，<strong>公安机关已依法对其进行传唤</strong>，开展了调查取证等工作。目前，案件正在办理中。</span></p><section style='margin-bottom: 20px;'><span style='color: rgb(0, 122, 170);'><strong><span style='font-size: 18px;'>国家医保局派工作组赴山东单县督办</span></strong></span><span style='font-size: 18px;color: rgb(0, 122, 170);'><strong><br></strong></span></section><section style='margin-bottom: 20px;line-height: 2em;'><span style='font-size: 15px;'>18日，国家医疗保障局基金监管司负责人表示，国家医保局高度重视社会反映的山东省菏泽市单县城乡居民医保涉嫌欺诈骗保问题，迅速责成山东省医疗保障局查明情况，依法依规严肃处理，并派出工作组，奔赴山东省单县进行现场督办。</span></section><section data-author="Wxeditor" style='outline: 0px; max-width: 100%; box-sizing: border-box !important;'><p style='text-align: center; outline: 0px; letter-spacing: 0.544px; font-family: -apple-system, system-ui, Arial, sans-serif;'><span style='outline: 0px; color: rgb(0, 0, 0); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 10px;'>（来源：央视新闻）</span></p><p style='text-align: center; outline: 0px; letter-spacing: 0.544px; font-family: -apple-system, system-ui, Arial, sans-serif;'><span style='outline: 0px; color: rgb(0, 0, 0); font-family: -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 10px;'><img src="http://www.yewn.cn/data/attachment/forum/202110/18/222819gssd4xt0a4tsd3rd.jpg"></span></p><section class="channels_iframe_wrp"><mpvideosnap class="js_uneditable custom_select_card channels_iframe" data-pluginname="videosnap" data-id="export/UzFfAgtgekIEAQAAAAAAO0IFyULHCgAAAAstQy6ubaLX4KHWvLEZgBPE2oMIMlA8OcH9zNPgMIvLGlnH9LOmAWTtd83uResL" data-url="https://findermp.video.qq.com/251/20304/stodownload?encfilekey=XGocBFxVWK5dcyOOqpEU47RpBHQIvlhn0mwQXX8zWUjkPpba2dYLyEa33hHFz4SibFFBSSbMTA12txJyyDvbgeIrtKNaRL9hxRPNU2ib5WNLg4eawbLr6jfticjuqas0AWSuDP629Jl0m5ibUTsVsGvSN7Lncc2pGYhq9YiaVY4UK4vvZ41QQUPQS2A&adaptivelytrans=0&bizid=1023&dotrans=0&hy=SH&idx=1&m=c9f6a6a6a9b091f72e38aceff71e5378&token=AxricY7RBHdW3H2tUU5XflXb43OHHeYWcLLN2NZCs35r9nBeSIOyPeHgfVTI9LKBlRJ1YicP5Fvek" data-headimgurl="http://wx.qlogo.cn/finderhead/zsUXYY6y4cI9c0ueNiciaKELe694M6vFSDUFrwkYZqEzUAC2s8kQOXng/0" data-username="v2_060000231003b20faec8c4e4801ec3dcc90ce531b0771c84fb16ccc0795b78050558a3e0b260@finder" data-nickname="荣耀渭南网" data-desc="渭南沋河水库惊现野猪" data-nonceid="10161132833134293326" data-type="video"></mpvideosnap></section></section></di> 监管不到位什么情况
具体什么情况？
漏洞太多
监管不到位啊
监管漏洞百出
监管制度不完善
聪明反比聪明误
这就是合疗年年涨价的原因