Viewpoint... The legal risk of lending a health insurance card.
Published:
2023-12-25
Administrative Responsibility of 1. Lending Medical Insurance Card
The act of lending one's medical security certificate to others for medical treatment violates the "Regulations on the Supervision and Administration of the Use of Medical Security Funds" and other provisions, and should be punished in accordance with corresponding laws and regulations.
According to Article 41 of the Regulations on the Supervision and Administration of the Use of Medical Security Funds, those who hand over their medical security certificates to others for use under a false name shall be ordered by the medical security administrative department to make corrections; if losses are caused to the medical security fund, they shall be ordered to return; they belong to For insured persons, the online settlement of medical expenses shall be suspended for 3 to 12 months. For the purpose of defrauding the medical security fund, if his medical security certificate is handed over to another person for use under a false name, the medical security administrative department shall impose a fine of 2 times to 5 times the amount defrauded.
Criminal Liability of 2. Lending Medical Insurance Card
Lending a medical insurance card for the purpose of defrauding a medical insurance fund and defrauding a large amount of medical insurance fund may constitute a crime of fraud.
According to Article 266 of the Criminal Law, the crime of fraud refers to the act of using deception methods to defraud a large amount of public and private property for the purpose of illegal possession. The purpose of borrowing other people's medical insurance cards to buy drugs and resell them for profit is to illegally occupy public and private property. By using other people's medical insurance cards, the medical insurance fund management agency mistakenly believes that the lender is reimbursing medical expenses, thus wrongly paying the medical insurance fund. The borrower obtained illegal income, which is in line with the constitutive elements of the crime of fraud.
Although the lender does not directly commit the fraud, it may constitute an accessory to the crime of fraud. Article 27 of the Criminal Law stipulates that "a person who plays a secondary or auxiliary role in a joint crime is an accessory". It is the lender's behavior of lending the medical insurance card that causes the medical insurance fund management organ to have a wrong understanding of the subject of medical insurance expense reimbursement and reimburse the medical expenses that should not be reimbursed. Therefore, the lender plays an auxiliary role in the process of insurance fraud, and its behavior infringes on the national medical insurance fund system and causes the loss of national social property. If the party concerned knows that the borrower may resell the drugs when lending the medical insurance card, he has the criminal intention in the criminal law and is suspected of constituting an accessory to the crime of fraud.
3. related cases
Case one:
(2013) Yang Xingchu Zi No. 872 Criminal Judgment
(2014) Shanghai No.2 Middle School Punishment Final Word No. 965 Criminal Judgment
Wang Jia, Xue Moumou, Wang Yi, and Yuan Moumou handed over their medical insurance certificates to the defendant Jiang Moutian for use in order to seek improper benefits, causing the medical insurance fund to be deceived. The defendant Wang Jia committed a huge amount of crime, and the defendants Xue Moumou, Wang Yi, Yuan Moumou committed a large amount of crime. Wang Jia, Xue Moumou, Wang Yi, and Yuan Moumou should be punished according to law. The defendants Wang Jia, Xue Moumou, Wang Yi and Yuan Moumou played a secondary role in the joint crime and were accomplices. In order to enforce the national law, safeguard the basic medical system for urban employees, and protect the ownership of medical insurance funds from infringement, in accordance with the provisions of Article 266, Article 25, paragraph 1, and Article 27 of the the People's Republic of China Criminal Law, the defendant Wang Jia was sentenced to fraud, sentenced to one year and eight months in prison, and a fine of 3,000 yuan. Defendant Xue Moumou was sentenced to fixed-term imprisonment of one year and two months and a fine of 2,000 yuan. Defendant Wang Yi committed fraud, he was sentenced to one year and two months' imprisonment and a fine of 2000 yuan; the defendant yuan was sentenced to six months' imprisonment, suspended for one year, and fined 1000 yuan.
The court of second instance upheld the original verdict.
Case two:
(2023) Shanghai 0113 Criminal Judgment No. 1002 at the Beginning of Punishment
Since 2021, the defendants he, Zhou and others have rented and lent their medical insurance cards to Liu for many times at prices ranging from 200 yuan to 500 yuan in order to seek illegal benefits. Liu went to XX Hospital in XX New District of the city and other hospitals to fabricate the reasons for seeing a doctor, use the above-mentioned medical insurance cards to purchase relevant drugs, and then resell them for profit, resulting in the loss of the national medical insurance fund. The court held that the defendants he, Zhou and others, for the purpose of illegal possession, rented and lent medical insurance cards to Liu for many times, and Liu fabricated the reasons for medical treatment and defrauded the medical insurance fund in a large amount, and their acts all constituted the crime of fraud and should be punished according to law. He and Zhou played an auxiliary role in the middle of the fraud activities and were accomplices. He committed the crime of fraud and was sentenced to one year's imprisonment, suspended for one year, and fined RMB 10,000; Zhou committed the crime of fraud and was sentenced to one year and six months in prison, suspended for one year and six months, and fined RMB 16,000 yuan.
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