我国定点医疗机构医疗保险相关违规行为及其监管研究

我国医疗保险制度不断发展和完善，在解决群众“看病难、看病贵”问题上发挥了重要作用。但由于相关配套政策尚不完善、监管机制不健全等原因，出现了一系列骗取、套取医保资金的违法、违规行为．给国家和人民造成很大的经济损失。本文主要从定点医疗机构医保相关违规行为的现象入手，分析违规行为产生的原因和形成机制，总结各地工作经验，并提出政策建议。以期为卫生行政部门下一步工作提供参考依据。

Research on Violation Behaviors at Appointed Medical Insurance and its Regulation in China

The regular improvement and enhancement in the national medical insurance policy have played a decisive role in solving hard to treatment,expensive to treatmentproblem.However,due to some other reasons,such as insufficient supporting policies,low-effective regulation mechanism,a series of law-breaking and regulation-violation behavior occurs,such as medical insurance cheat,which caused drastic economic damage to the nation and the people.Through starting from some relevant regulation-violation of appointed ...