A Study On The Crime Of Defrauding Medical Insurance Funds In Designated Private Hospitals

On April 24,2014,the Standing Committee of the National People’s Congress promulgated the legislative interpretation of Article 30 and Article 266 of the Criminal Law of the People’s Republic of China.On the contrary,the judicial practice circles did not stop the qualitative disputes over the behavior of designated private hospitals to cheat medical insurance funds.The introduction of the legislative interpretation of Article 30 and Article 266 of the Criminal Law intensifies the dispute over whether the act of defrauding medical insurance fund by designated private hospitals should be regarded as a crime of fraud or a crime of contract fraud.To this end,the author retrieved 92 judicial documents of 69 real cases in which designated hospitals defraud medical insurance fund through China Judicial Document Network.Through sorting and analyzing the judicial documents,the author found three reasons for the qualitative inconsistency of designated private hospitals defrauding medical insurance fund in judicial practice.The first is in legislation."Criminal law" article 30 and article two hundred and sixty-six of the legislative interpretation,article two hundred and sixty-six of the criminal law legislation "otherwise provided for in this law,in accordance with the provisions of article two hundred and twenty-four of the criminal law,article two hundred and thirty-one of the mismatch between,the second is about the concept of unit crime criminal law is not clear,three is the health care medical establishment that decide a dot medical service agreement unclear legal nature,Combined with fixed-point private hospitals to defraud the behavior characteristics of medical insurance fund,and the judicial status quo,one-on-one three reason,draw a fixed-point civilian battalion hospital diddle medical insurance fund behavior should be the crime of fraud of the contract,convicted and punished in conformity with the unit crime constitutions,committing the crime of fraud of the contract conclusion of convicted and punished in unit,and put forward the problems should pay attention to in the judicial practice,In order to hope to theoretical research and judicial practice to provide some help.