Research On Criminal Regulation Of Social Medical Insurance Fraud In China

Social medical insurance system refers to the country by basic social medical insurance system legislation,personal illness or go to a doctor,in specific participants need to pay the basic social medical insurance personal related fees of participants and provide relief demand and guarantee of the basic medical insurance system of basic social insurance in our country has been plays an important role in medical insurance system.With the rapid development of China’s market economy and the increasing popularity of social medical insurance,fraud and crime in the field of social basic medical insurance are increasingly rampant in China.Social medical insurance fraud mainly for the purpose of illegal possession,seriously overdrew the social basic medical insurance fund,a large amount of social medical insurance resources waste,blocked the social basic medical insurance to ensure the full play of the role.Apart from the introduction and conclusion,this paper is mainly expanded from the following four parts:The first part is the overview of the social medical insurance fraud and the related regulation of penalty.The connotation of social medical insurance fraud mainly refers to the illegal behavior that the applicant,the social basic medical service management organization and the social medical insurance handling management organization intentionally conceal or provide false medical information to defraud a large amount of social medical insurance fund.Social medical insurance fraud fraud means diversification,fraud subject diversity,concealment of the fraud,wide Qian Che Mian associated behaviors,such as the main characteristics,the forms of the social medical insurance fraud including ginseng protect people or legal beneficiary of fraud,social medical insurance agencies on the implementation of fraud,Fraud committed by the social health insurance service.The social medical insurance system is the most complicated system in China’s existing social insurance system,and the frauds and crimes in the field of social basic medical insurance are becoming more and more serious.Therefore,it is necessary to regulate social medical insurance fraud by criminal law.The second part is the analysis of the current situation of the criminal regulation of social medical insurance fraud in China.Through consulting the typical cases in the Judicial Document Network,it is found that China’s current criminal regulations on social medical insurance fraud mainly include the following:Through the analysis of three typical cases:Deng Shuyue’s fraud case,Chenggangli’s insurance fraud case,and Tianmen Hanjiang Hospital’s contract fraud case,it shows that the current situation of the criminal regulation of social medical insurance fraud in China still has some shortcomings.Secondly,through the evaluation and analysis of the criminal regulation of social medical insurance fraud in China,the social insurance fraud in practice is mostly regulated by the crime of fraud,insurance fraud and contract fraud.The irrationality of this treatment mainly includes:The subject scope of these three charges is difficult to cover the subject of social insurance fraud,there is deviation in the protection of legal interests,and the regulation of criminal law is too moderate.The third part is the investigation of the legal regulation of social medical insurance fraud outside the territory.At present,China’s criminal regulation of social medical insurance fraud is not perfect,and the crackdown on criminal behavior is not strong.In improving the criminal regulation of social medical insurance fraud,we can learn from the punishment methods of other fraud crimes in China’s criminal law,and also learn from the legislative experience and judicial practice outside the region.Therefore,this paper studies the relevant criminal regulations of Britain,the United States and Germany,and finally summarizes the regulation characteristics of criminal laws of various countries on social medical insurance fraud and its enlightenment significance to China,including setting independent charges,stipulating specific fines,and implementing severe penalty measures.The fourth part is our country social medical insurance fraud criminal regulation suggestion.First of all,the crime of social insurance fraud should be set separately.In the field of judicial practice,there are criminal acts of different degrees in the fields of social insurance such as pension,industrial injury,unemployment and childbirth.In order to make the crimes in the field of social insurance have laws to follow,it is more reasonable to set up the crime of social insurance fraud alone in the criminal law.Secondly,it clearly defines the scope of the subject of the crime of social insurance fraud,in addition to the natural person,the unit should also be included in it.In addition,the behavior mode of social insurance fraud should be clearly listed,and the behavior mode of crime should be discussed with the subject as the standard.Finally,improve the sentencing standards of the crime of social insurance fund fraud,such as: adopt higher than the general crime of fraud imprisonment years and fine amount,adopt the combination of crime amount standard and crime circumstances standard identification,unit crime with reference to the natural person crime to set the sentencing standard.