目的: 医疗保障执法部门与司法机关在证据收集、固定及采信方面存在职能分工与法律标准上的差异,二者既相互衔接又各有侧重。为解决医保行政执法证据与司法证据转化不畅的问题,医疗保障执法部门收集的证据需具备刑事诉讼所需的证据能力。方法: 采用规范分析法与实证研究法,对证据审查机制开展形式与实质的本体论研究。通过中国裁判文书网收集北京地区涉医保基金刑事案件,用统计分析方法重点关注年份、案由、犯罪行为模式、证据名称等数据。结果: 基于理论与实证的分析,总结出书证、电子数据、视听资料、询问笔录、鉴定意见等证据固定要点。结论: 在行政执法阶段即按照刑事证据标准规范取证,能有效实现行刑衔接,确保案件顺利进入司法程序并获得公正裁判。

Objective: There are differences in functional division and legal standards between healthcare security administrative law enforcement agencies and judicial authorities regarding evidence collection, fixation, and admissibility. While the two systems are interconnected, each has its own focus. To address the issue of insufficient conversion of administrative law enforcement evidence into judicial evidence in healthcare security cases, evidence collected by healthcare security law enforcement departments must meet the evidentiary requirements for criminal proceedings. Methods: Normative analysis and empirical research methods were employed to conduct ontological research on the form and substance of the evidence review mechanism. Criminal cases related to medical insurance funds in Beijing City were collected from the China Judgments Online database, with statistical analysis focusing on data such as year, cause of action, criminal behavior patterns, and titles of evidence. Results: Based on theoretical and empirical analysis, key points for evidence fixation were summarized, including documentary evidence, electronic data, audio-visual materials, inquiry transcripts, and expert opinions. Conclusion: Standardizing evidence collection in accordance with criminal evidence standards during the administrative law enforcement stage can effectively bridge the gap between administrative and criminal proceedings, ensuring cases smoothly enter judicial procedures and receive fair adjudication.