Strengthening the regular supervision of the medical insurance funds use will improve the detection rate of illegal use and defaulting of medical insurance funds, but this paper believes that its specific goal should be effectively deter the illegal behaviors and defaulting above with less supervision and law enforcement costs, so as to maximize the law-abiding and compliance with the limited law enforcement resources. At this stage, China's medical insurance fund supervision still has problems such as limited law enforcement resources and supervision capacity. This paper elaborates on the connotation and specific goals of regular supervision of the use of medical insurance funds, and believes that the following three paths can be used to achieve the goals above, i.e. strengthening and improving intelligent supervision of medical insurance funds, innovating, optimizing, and comprehensively using various regulatory methods, strengthening self-management of designated medical institutions and pharmacies, and innovating systems such as no penalty in case of compliance.
Key words
medical security fund /
regular supervision /
regulatory method optimization /
regulatory objectives /
implementation path
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References
[1] 陈兵,夏迪旸.平台经济常态化监管的路径研究[J].中国市场监管研究,2023(03):30-35.
[2] GARY S.BECKER.Crime and punishment: an economic approach[J].Journal of political economy,1968,76:169-217.
[3] 国务院办公厅.关于加强医疗保障基金使用常态化监管的实施意见:国办发〔2023〕17号[EB/OL].(2023-05-30)[2023-08-18].https://www.gov.cn/zhengce/zhengceku/202305/content_6883812.htm.
[4] GUNNINGHAM N, SINCLAIR, D.'Smart regulation', in Peter Drahos (ed.)[J].Regulatory theory: foundations and applications, ANU ePress, Canberra, Australia, pp.133-148.
[5] 张卿.现阶段医疗保障基金监管的最优执法理念和共治路径研究[J].中国医疗保险,2021(05):35-39.
[6] 最高人民法院,最高人民检察院.关于办理诈骗刑事案件具体应用法律若干问题的解释(法释〔2011〕7号)[Z].2011.