医疗保险基金欺诈骗保及反欺诈研究【摘要】本文主要从医疗保险基金的本质特点及表现类型，透析出现医疗保险基金欺诈骗保的漏洞，从根本出发，了解医疗保险基金制度的弊端；了解医疗保险基金欺诈骗保的社会状况，认识欺诈骗保的主要表现形式，并分析出现欺诈行为的重要原因。借鉴美国的医疗保险反欺诈的成功举措，了解我国反欺诈研究内容的欠缺部分，根据我国国情和医保发展的实际情况，提出反欺诈的方案。了解群众欺诈骗保的不平衡心理，引导群众加强法制观念，遵守医保制度，守住道德底线。若对医疗保险基金欺诈骗保不及时采取有效措施，其带来的后果不止是对医保基金池的削减，还有对医保机构甚至是政府部门公信力的削弱，造成消极的社会效应。因如何完善我国反欺诈体系才能够从根本上减少欺诈骗保行为，维护医疗保险基金安全，保障参保者的“救命钱”，正是本文将要探讨的问题所在。【关键词】医疗保险基金制度；欺诈；反欺诈注：本论文（设计）题目来源于教师的国家级（或省部级、厅级、市级、校级、企业）科研项目，项目编号为： 。Research on Medical Insurance Fund Fraud and Anti-fraud[Abstract] This article focuses on the essential characteristics and types of performance of medical insurance funds, dialysis the loopholes of medical insurance fund fraud and fraud, from the fundamental point of view, understand the malpractice of medical insurance fund system; understand the social situation of medical insurance fund fraud and insurance, understand fraud The main manifestation of insurance, and analyze the important reasons for fraud. Drawing on the successful anti-fraud measures of medical insurance in the United States, understanding the shortcomings of anti-fraud research in China, and proposing anti-fraud solutions based on China's national conditions and the actual development of medical insurance. Understand the unbalanced psychology of the masses to defraud and insurance, guide the masses to strengthen the legal concept, abide by the medical insurance system, and keep the moral bottom line....
