Social Security Fraud Legal Regulation Research

In the domestic social security system,social medical insurance is one of the key parts,which is the need to protect people's health,the need of socialist construction,but also an important measure to ensure social stability.However,from the overall perspective,at this stage,the domestic social medical insurance is still imperfect,medical insurance fraud often occurs,and has a rapid development momentum.The reason why the insurance system is set up is mainly to make the people better deal with the uncertain risks.However,some people are willing to engage in insurance fraud in order to pursue interests.They mainly start from the weak links of the medical insurance system to gain profits from fraud,which will inevitably require the construction and development of relevant laws and regulations on insurance and fraud prevention.However,the current actual situation is that:,There is a lack of relevant laws and regulations on insurance fraud prevention in China,which also leads to the repeated prohibition of medical insurance fraud,unable to guarantee the effective governance of medical insurance fraud at the legal level.Therefore,in this paper,we have carried out an in-depth analysis of the legal regulation of medical insurance fraud in China,analyzed the current situation,found out some prominent problems and deficiencies,and combined with foreign practical experience in this area,finally gave a more feasible proposal to improve,in order to promote the further development of social medical insurance in China.This paper has four parts:The first part is about the theory of medical insurance fraud.This part seems to be simple,but it is actually the theoretical support point of the whole article and the key to ensure that the article has a certain theoretical level.Compared with other insurance fraud,social insurance fraud has its own characteristics.It is a legal relationship established on the basis of three parties.One is the insured,one is the medical service institution,and the other is the social insurance institution.Because of its complexity and uncertainty,the current social insurance fraud is more prominent.The anti fraud in this respect is based on the means and current situation of social medical insurance fraud at this stage,which is obviously preventive.In the second part,it is elaborated that the current domestic social insurance fraud laws and regulations are the actual status quo,at the same time,it analyzes some prominent problems existing in them from the status quo,and carries out a more detailed analysis of the problems.The third part describes the successful experience of three countries in the field of anti fraud of medical insurance.These three countries are the United States,Britain and Germany,and carry out analysis at different levels.At the same time,it summarizes some specific enlightenment for domestic in this area,so as to help the establishment and development of domestic laws and regulations in this area.In the fourth part,based on the problems analyzed in the third part,referring to foreign experience,focusing on the actual situation of our country,some feasible suggestions are given to promote the further development of social medical insurance in China.