医保部门专项行动一般都安排有检查时段,但行政处罚案件对违法行为的追究时效有明确的要求,如何处理检查时段与追究时效的关系是办案机关直接面临的业务难题。在医保领域法律另有规定前,遵从法理,正确区分违法行为独立发生、连续发生和呈继续状态三种情形,才能不枉法,不纵法,合法合规处理好各类医保行政处罚案件。本文从行政执法业务角度出发,提出对医保行政处罚案件追究时效的处理建议。

The special actions of the medical insurance departments usually specify inspection periods, but administrative punishment cases have clear requirements on the time limit for illegal acts. How to deal with the relationship between the inspection period and the investigation limitation is a direct problem faced by the authorities. Before there is other provisions in the field of medical insurance, we must abide by the legal principle and correctly distinguish three cases of illegal acts, which are independent occurrence, continuous occurrence and continuous state, so as not to pervert the law, and deal with all kinds of medical insurance administrative punishment cases according to laws and regulations. From the perspective of administrative law enforcement, this paper puts forward some suggestions on the investigation limitation of medical insurance administrative punishment cases.