Study On Anti-fraud Legal Systems For Social Medical Insurance In Our Country

Social medical insurance is an important aspect of the social security system inour country. The effective implementation of this system can be beneficial to the rapiddevelopment of the National Health Service. However there is only a few years sincethe since the system has been preliminary established. It is still at the start stage inChina, and has not formed the perfect system. It led to the social medical insurancefraud is becoming more and more serious. This paper is aiming at the currentsituation and existing defect of china on this issue and try to find an effective way toanti-fraud.This article divides into four parts. The first part mainly introduces the theoryof social medical insurance fraud and anti-fraud. It includes the definition of relatedconcepts and the characteristics, causes and ways of social medical insurance fraud.And then Analyze of the necessity of anti-fraud. The second part mainly introducesthe experience in medical insurance anti-fraud of three foreign countries. Thenanalyze and summarize several issues which are worth learning from their medicalinsurance anti-fraud. The third section describes the legal status of our country’ssocial medical insurance anti-fraud system and then analyzed the shortage of presentstatus. The fourth part is mainly about how to optimize the anti-fraud system.According to our county’s present situation and using the experience in foreigncounties as a reference, this part puts forward the corresponding measures to improvethe system concerning the problems in it.