Tomorrow 09/02 (Monday) light rain 18~26° South wind 1 level Excellent
31st August
The National Medical Security Administration revealed that
Several hospitals provide gynecological treatment for men
Details are as follows↓
Procedures such as “Hysteroscopy examination,” “Cervical cancer screening,” and “Cervical dilatation” all fall under gynecological treatment. Surprisingly, some male patients have incurred such medical insurance expenses. In certain hospitals, they have even conducted 1674 of these “eccentric” examinations in a year. Health insurance departments nationwide, following a unified arrangement, are meticulously verifying the big data issues provided by the National Medical Security Administration.
What is the situation with men receiving gynecological treatment?
Some involve healthcare institutions swapping projects to defraud medical insurance. For example, Leiyang People’s Hospital in Hengyang City, Hunan Province, converted self-funded projects that are not covered by medical insurance into reimbursable projects by charging for “Intrauterine color Doppler ultrasound (transvaginal).” Similarly, San Yi Yi Hospital in Zhuzhou City, Hunan Province, substituted a self-funded project of “Painless gastroscopy anesthesia” (74 yuan/time) with a Category B project of “Hysteroscopy anesthesia” (450 yuan/time) for reimbursement. These actions result in a large number of male patients incurring gynecological treatment expenses. Why would they do this? To defraud medical insurance!
Some involve medical personnel allowing female patients to use male-insured persons’ eligibility for medical treatment. For instance, medical personnel at Wang Yanjun Clinic in Alxa League, Inner Mongolia Autonomous Region, allowed female patients to use male family members’ medical security certificates for expense settlement after conducting “Transvaginal color Doppler ultrasound.” Li, a male worker at Yuxiang Branch of a Livestock and Poultry Company in Hunan, had his female family members receive gynecological treatment at Yueyang Central Hospital, Hunan in September 2023, December 2023, and April 2024, all expenses being settled using Li’s medical insurance card.
Which healthcare institutions and doctors have the highest number of violations?
Table 1 lists the healthcare institutions with high rankings in providing gynecological treatment to men↓
Table 2 lists the doctors with high rankings in providing gynecological treatment to men↓
Next, the health insurance departments in various regions, under the guidance of the National Medical Security Administration, will extrapolate from local situations, expand the screening scope, and ensure the thorough investigation and settlement of gender-related abnormal billing issues in the region.
The net of heaven is vast and meshes everything without leaving a gap
In the face of big data,
Can we still differentiate between male and female correctly?
-END-
Design| Yang Dayao
Source| National Medical Security Administration
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The net of heaven is vast and meshes everything without leaving a gap!
