A Study On The Legal Dilemmas Of The Crime Of Defrauding Medical Insurance Funds

The Medical Insurance Funds is a part of public property and its safety related to public interests.The number of cases involving defrauding the Medical Insurance Funds is increasing nowadays,which has seriously affected the smooth and safe operation of the Medical Insurance Funds,and has great social harm.Due to the complicity of its criminal subjects,the variety of its criminal means and the intricacy of the related laws and statues,the Medical Insurance Funds related case brings dilemmas in judging guilty and its nature.In respect to identifying it is a criminal offense or an administrative offense,the register criterion of the Crime of Defrauding Medical Insurance Funds shall follow the register criterion of common defrauding crime.When handle the offense,focusing on the connection between a criminal offense and an administrative offense is a must.By the means of over-treatment to defraud the Medical Insurance Funds may offend the criminal law as the Crime of Defrauding Medical Insurance Funds.In respect to identifying the nature of the crime,defrauding the Medical Insurance Funds shall be charged of the Crime of Defrauding instead of the Crime of Insurance Defrauding or the Crime of Contract Defrauding,in accordance with the Judicial Interpretation of the Article266 of the Criminal Law.In respect to identifying it is a unit crime or not,the Crime of Defrauding Medical Insurance Funds conducted by a medical agency is not a unit crime.Nevertheless,the members of the agency may be accused of the Crime of Defrauding.In respect to the issue of joint crime,the members of the medical insurance institute together with outsiders conspire to defraud the Medical Insurance Funds constitutes the Crime of Embezzlement.In respect to the criminal amount and the crime patterns,the criminal amount calculation shall be solidly based on the fact proved by the existing evidence and follow the rule Good To the Suspects.Whether the crime is completed bases on the control completion of the Medical Insurance Funds.The specific settlement method of the Medical Insurance Funds is a significant factor that decides the criminal mounts under different criminal patterns.