A few days ago, a patient reported that the Second People’s Hospital of Wuhu City, Anhui Province (hereinafter referred to as "Wuhu Second Hospital") overcharged medical expenses, which aroused strong concern in the industry about "excessive diagnosis and treatment".

On December 2nd, Anhui Medical Insurance Bureau informed the Second Hospital of Wuhu about the illegal use of medical insurance funds, and on the 4th, official website of Hunan Medical Insurance Bureau issued the "Administrative Punishment of Xiangya Hospital of Central South University", which fined the hospital about 980,000 yuan for illegal use of medical insurance funds.

CBN found that in recent years, the Regulations on the Supervision and Administration of the Use of Medical Insurance Funds (hereinafter referred to as the Administrative Regulations) and the Interim Measures for the Supervision and Administration of the Use of Medical Insurance Funds (hereinafter referred to as the Interim Measures) and other laws and regulations have been promulgated one after another, providing policy and legal basis for the supervision of medical insurance funds; As a complement to the Interim Measures, the Measures for Reporting Incentives for Illegal Use of Medical Insurance Funds (hereinafter referred to as the "Incentive Measures") was also released in November 2022. This document is to mobilize social forces to participate in fund supervision and safeguard the safety of medical insurance funds.

The National Medical Insurance Bureau has repeatedly stressed that the medical insurance fund will never become "Tang monk meat". According to official data, since 2019, the National Medical Insurance Bureau has sent a total of 184 flight inspection teams to inspect 384 designated medical institutions, and found that 4.35 billion yuan of related funds were used illegally. Since the implementation of the "Incentive Measures" in January this year, medical insurance departments at all levels across the country have verified and recovered the amount of medical insurance violations of 158 million yuan according to the clues reported by the masses.

An expert on medical insurance policy told CBN that with the increasing efforts to crack down on fraudulent medical insurance in China, blatant fraudulent medical insurance behaviors such as "fake patients", "fake services", "fake medical products" and "fake medical insurance expenses" have been effectively curbed, but some fraudulent medical insurance behaviors have also shifted from the front to the back, and gradually changed to behaviors such as excessive medical treatment and excessive fees. How to determine the boundary of excessive medical treatment and how to adopt scientific and accurate comprehensive management methods are the key points in the next stage.

The boundary of "excessive diagnosis and treatment"

According to the notification of Anhui Medical Insurance Bureau, Wuhu Medical Insurance Bureau has fully recovered the medical insurance fund illegally used by Wuhu Second Hospital according to the medical insurance service agreement signed by the hospital, and deducted the liquidated damages at 30%, interviewed the relevant person in charge of the hospital, and handed it over to the public security and health care departments for further verification. At the same time, the bureau has started the administrative punishment procedure in accordance with the Management Regulations.

"Medical insurance service agreements are handled in different ways, but most medical institutions deduct liquidated damages at a rate of 30%." A person in charge of the medical reform department of a health and wellness commission in the southern region told the reporter that in addition to the treatment method according to the medical insurance service agreement, in the administrative punishment procedure, the above-mentioned "Management Regulations" stipulates that illegal acts that cause losses to the medical insurance fund shall be ordered to return, and a fine of more than 1 time and less than 2 times shall be imposed.

Zhao Dahai, a professor at the School of International and Public Affairs of Shanghai Jiaotong University, told the First Financial Reporter that whether it is for medical institutions or medical staff, the end of over-diagnosis and treatment must bring economic returns to themselves and institutions (institutions also involve scale expansion), but in the final analysis, the supervision of medical insurance funds needs a set of strict, scientific and legally effective standards to judge and identify.

"For public hospitals, we can constantly correct their use of medical insurance funds by strengthening supervision, but private hospitals and pharmacies have certain commercial attributes, so we still need to rely on effective supervision methods when avoiding the risk of fraudulent insurance." Zhao Dahai said that in the next stage, health care and medical insurance departments can jointly promote the standardization and implementation of clinical diagnosis and treatment paths.

To this end, the person in charge of the medical insurance service department of a top-three hospital in Beijing said that at any time, medical institutions should never make profits by prescribing drugs and consumables without collecting the information of the insured. This is malicious fraud and insurance fraud, and it is also the bottom line problem. However, at this stage, it is not uncommon for medical institutions to occupy too much medical insurance funds by improving the accessibility of drugs and consumables.

"But whether this belongs to’ excessive diagnosis and treatment’ needs to be viewed objectively." The person in charge said that on the one hand, some innovative drugs are expensive but have great benefits to diseases, and doctors prescribe them for patients out of kindness. However, due to the annual update of the medical insurance catalogue, whether the innovative drugs are still within the scope of the medical insurance catalogue, whether the medical insurance limited payment ratio has been adjusted, and whether the patient’s area is applicable need further careful confirmation. On the other hand, the scope of medical insurance fund’s limited payment needs to refer to a number of matters, including the indications in the drug instructions and the reimbursement ratio of the insured’s location. "It is almost impossible for doctors to record all the contents and ensure that there are no mistakes. Therefore, it is imperative to introduce an information-assisted platform and do a good job in training."

Is there a solution to the problem that medical institutions illegally use medical insurance funds caused by "excessive diagnosis and treatment"?

Cai Haiqing, former director of the Treatment Protection Department of Jiangxi Provincial Medical Insurance Bureau, said that, first of all, it is necessary to solve the problem of how to identify "excessive diagnosis and treatment"; Secondly, with the comprehensive implementation of the reform of DRGs (Payment by Disease Diagnosis Group) and DIG (Payment by Disease Score), the problem of medical insurance payment currently facing the clinic is to solve the problem of "over-diagnosis and treatment" and to prevent possible insufficient diagnosis and treatment. "Insufficient diagnosis and treatment includes low-standard discharge, reducing necessary medical services and inspection items, and reducing the use of drugs and consumables. This situation is to reduce the cost of medical services and improve the yield."

As a matter of fact, the First Financial Reporter learned in the industry that it is difficult to identify, identify and dispose of over-medical treatment. In June this year, "Research on the Identification of Over-medical Treatment Behavior and the Regulation Rules of Medical Insurance" released the first "over-medical treatment index system". The theoretical basis of this system includes sampling data, written materials and written materials of fund supervision discussions of 121 designated medical insurance institutions in Shanghai. It involves 5 first-level indicators, 30 second-level indicators and 67 third-level indicators.

"Although the system is developed in the form of research, it is still some time before it is fully implemented, but at least it has broken the definition of the boundary of overtreatment." Cai Haiqing said.

Regulatory challenges

Since the beginning of this year, official website, the National Medical Insurance Bureau, has published 40 typical cases of fraudulent insurance in four phases. The illegal use of medical insurance funds includes: changing medical treatment items, falsely recording infusion drugs, treatment and inspection fees, forging materials, uploading false medication data, etc. Most of these cases were discovered by local medical insurance departments through active forms such as medical data verification in different places, big data screening and analysis, and on-site supervision and inspection.

On the basis of the previous vigorous rectification work, what are the challenges in the supervision of medical insurance funds and how to establish a long-term supervision mechanism?

To this end, Yu Changyong, an associate professor at the School of Public Administration of Zhongnan University of Economics and Law, told reporters that under the new situation, the new challenges of China’s medical insurance fund supervision can be interpreted from four aspects. First of all, after years of flight inspection and special work to combat fraud and insurance fraud, some "blatant" fraud and insurance fraud in the past have been effectively curbed, and the means of fraud and insurance fraud will be more subtle and the way of fraud will be more complicated.

Secondly, the overall level of medical insurance in various regions has been gradually improved, and the area where patients seek medical treatment has become larger, which will also significantly expand the scope of supervision of medical insurance funds and increase the difficulty of supervision. Thirdly, the reform of outpatient co-ordination makes the medical insurance department not only supervise the hospitalization behavior, but also supervise the outpatient behavior and the drug purchase behavior of pharmacies, and the objects and contents of supervision will show explosive growth.

In addition, the state attaches great importance to the development of Chinese medicine, and Chinese medicine services will be further included in the scope of medical insurance fund payment. However, Chinese medicine services are often treated by people and diseases, and its legal compliance or more difficult to judge, making it more difficult to supervise medical insurance funds.

To this end, Yu Changyong suggested that for some hidden and complicated illegal use of medical insurance funds, the medical insurance administrative department needs to be accurate and qualitative, and administer according to law; On the other hand, it is necessary to increase administrative punishment and even criminal punishment. In addition, it is necessary to strengthen the construction of intelligent monitoring and big data screening mechanisms, and establish a credit supervision system as soon as possible.

For the establishment of a long-term mechanism, a medical insurance fund supervisor said that in fact, in the past, the punishment for illegal use of medical insurance funds was mostly in medical institutions, and the punishment for individuals was not enough; At the same time, due to the low cost of violating laws and regulations, in most cases, it is ultimately handled in accordance with the medical insurance service agreement, and administrative punishment, transfer to justice or discipline inspection are rare.

"On the one hand, it is recommended that the medical insurance department unify the standards for law enforcement and incorporate illegal acts of medical institutions into credit management; On the other hand, medical institutions should establish the accountability system, reward and punishment system for the main leaders of the party and government and department heads, and improve the business training in the field of medical insurance payment. In addition, it is necessary to improve the comprehensive supervision mechanism that pays equal attention to incentives and constraints. Medical institutions that self-examine and self-correct and voluntarily return funds can reduce or not be punished. However, for those medical institutions and individuals who repeatedly check recidivism and do not change, they must be dealt with severely. " The source said.

This thing, everyone is not strange?

Yes, it is a breathing light.

It is used to remind the user to have a prompt lamp for notview information. With it, we only need to look at it, you can know if there is any information just now.

As a function of your mobile phone, the most touching function. But when it’s, it’s hard to be eaten.

At least in my impression, there is a suggestion on the Nokia function.

(Nokia E5)

In more than ten years, we don’t know, witnessed the classic cases of a lot of tips.

Like Samsung, under the on-screen panel, a secluded tips can be said to be the most traditional design.

Meizu ring breathing lights, integrating with Home, elegant and exquisite.

When there is information, the entire ring is slowly released, and slowly extinguish, like a nuclear reactor of the Iron Man chest.

In addition to the headless brand mobile phone, even hundreds of dollars of functional machines, there are also running horse breathing lights.

This, the iPhone user next door does not agree.

Some people open the iPhone, actions, and change the back LOGO to the breathing lamp.

It can be seen that people have a manner that the breathing lamp is not limited to its own function.

However, the good view is not long, with the arrival of the full screen, the border of the mobile phone is getting narrower and narrower, and the living space of the breathing lamp is squeezed.

(IPhone X Liu Haiping)

Of course, this is half a pseudo-proposition, because we can still see that there is a breath lamp in the side of the mobile phone.

At least, this tests the industrial design, and cost of the manufacturer.

(Red rice 10x breathing light built into the border)

Secondly, the presentation of the information big bombings, mobile phones have not received incoming calls and text messages, but also have to receive various app notifications.

People have also begun to change the usage habits of mobile phones. If there is something, there is nothing to illuminate, and the mobile phone almost "long" in the hands of people, the probability of missed the information is getting lower and lower.

Of course, the most deadly or the popularity of the OLED screen, let the "interest screen are always bright" into mainstream functions. Call or information will have a corresponding icon display.

This can be more intuitive than the breathing light.

This, the rice bowl of breathing lights directly.

With the function of smartphones, design homogenization, "interest screen display" is nothing, replacing the breathing lamp, has become a breakthrough in the manufacturer to show the brand identity.

With many factors, in recent years, we are more and more difficult to see, there is a breather’s mobile phone.

But many old users are unknown until they have changed new mobile phones, they found no breathing lights. Many people call online to let the manufacturers add the breathing lamp back.

However, the breathing lamp does not completely disappear, it is equipped with another form on the phone.

For example, Huawei P50 PRO is used, an electrochromic material is used. As the name suggests, it is a material that will discharmatically.

When the phone is called, the p50 Pro rear cover will energize, and the effect of breathing light is flashing.

There is also a fascinating, at this year’s Flyme9 conference, the MX2 classic circular breath lamp, and the vocal screen displayed.

But these are not real breathing lights, I want to say who play lights, or I have to read OPPO.

To say that OPPO, there is a lot of classic breathing lights. 7 years ago OPPO Find 7 skyline breathing lights, so far is the design of Find loyalty.

(OPPO Find 7 breathing light)

As well as the N3 star cyclic breathing lamp, you can get a classic breathing lamp.

(OPPO N3 breathing lamp)

This time, OPPO has brought new designs, Reno7 Pro "Star Ring" breathing lights.

This time, OPPO took the breathing lamp to the edge of the rear module.

The star cyclic ventilation light has a variety of setting options, such as charging, and the call is flashing, or even as a game atmosphere.

And, we can also specify the app to turn on light efficiency.

In different modes, Reno7 breathing lights have different colors.

Corresponding to the star cyclic breathing lamp, it is like a meteor shower. This back cover uses the space-grade star rain, and is precisely engraved on the star diamond glass.

Will a Dow Meteor, eternal engraved on the back cover.

Reno7 Pro uses a right angle design, only 7.45 mm thickness, the weight is controlled by 180g, which can be said to be kneaded.

OPPO is in such a thin body, it is stuffed a 4500mAh battery, and those who say that the light is not long, it can be said to be faced.

What’s more, Reno7 also supports 65W flash, and battery anxiety can be said to be worship.

The screen is a 6.55-inch OLED screen that supports 90Hz refresh rate. Due to the use of the straight screen, the screen accounts for 92.8%, and the border is only 1.55mm.

As a direct screen of the game, it is said that it is taken.

In photography, OPPO is directly to the Reno7 series, and the title of "Portrait Video Master" is not difficult to guess. The direction of this special attack is photography.

The front lens is 32 million pixels, which uses a new, sensor IMX709 customized with Sony depth.

This sensor integrates, OPPO self-developed RGBW image fusion units can have better photosensitive ability and color reducing capabilities.

Not only in the absence of light, take a gratifying self-timer, even if the backlight shooting, it can be very clear.

(Shooting shot)

Reno7 Pro is equipped with 50 million pixel main photos, and the sensor uses a new IMX766, and the effect of larger sensors is obvious.

From the main photographing photos, it can be seen that both the details or the overall brightness, Reno7 Pro has been controlled very good, and the picture color is very good.

(Main shooting)

Reno7’s super wide angle view range, reached 118.9 °, and there is still a bit worried about edge distortion at the beginning.

But actually shooting, I have more considerable consideration, Reno7 is still very good to correct the distortion.

And under the tuning of OPPO, the picture, color is consistent with the main experience.

(Super wide angle shooting)

In terms of performance, the processor of Reno7 PRO is Tianzhu 1200-Max, as well as UFS3.1 memory, LPDDR5 storage blessings.

Machine brother also tested the game of "King", after opening the ultra-high frame rate mode, half an hour’s average frame rate 88.4 fps, can be said to be very stable.

On this basis, OPPO is equipped with "Super Lightning Start 2.0", combined with "game pre-update 2.0", can directly skip the game update, one button is black.

Can’t help but say, mainly the return of the breathing light, let people live "Lan Qing back".

But as for the future, the breathing lamp will not completely disappear, I also can’t say it.

Before, there was a netizen to say why it is not invented to remove the mobile phone battery so that the mobile phone is not electricity to change the battery, saving more time.

Many old netizens, including the opportunity to see, the heart is both bitter, but also helpless.

For so many years, do you have to go far from our headphones and detachable batteries?

If the child later, I suddenly asked me: "Why light the screen can you know if there is any information. Directly install a message tips, isn’t it good?"

I may really don’t know how to return him, it is possible, this is the Renaissance …

Line 9 Gu Tang Road Metro Station is pure new. Pudong Caolu Merchants Bright City Exhibition Hall has been opened. It is located in the northeast corner of the intersection of Jinzhao Road, Gu Tang Road. It is expected to enter the market in the second quarter.

The project first launched 348 suite land

The main push construction surface is about 105-135 square meters 3-4 room

Hardcover, rough delivery

The linked price of the house is 45,000/㎡!

In the capital verification, the first set of 2 million, two 4 million.

The average residential price is expected to be 57,000/㎡

According to the plan, a total of 6 high-rise houses are built with a product of 105-135 square meters. Among them, 7#is self -sustaining for developers, 1#, 2#, 3#, 5#are all 105㎡ units (1#3#hardcover 2#5#blank), and 6#are all 135㎡ units.

A total of 416 suites, 204 units of 105㎡ units, 144 rough blank, and 68 units of 135㎡ apartment.

Open 1#, 2#, 3#, 5#105㎡ units.

Sales Hotline?: 400-8123-224

Empower the city upgrade, China Merchants Shekou’s bright new voice

As China’s leading cities and park operation service providers, China Merchants Shekou has deeply cultivated Shanghai, constantly helping urban development with high -quality works, and is committed to becoming a bearer of a better life.

In 2022, China Merchants Shekou Shanghai’s company was ingenious, and its strength layout was diversified, creating more good possibilities for cities. The new "6D" TOD work created by China Merchants Shekou United Midea at Gu Tang Road Station, Pudong Line 9-China Merchants · Bright CityEssence

Bright City as China Merchants Shekou new exploration TOD complex worksReterable to the relationship between people and cities, people and life, stand on the development of Pudong, and create a new model of TOD life for cities more convenient and comfortable.

Diagram

The planning and renderings of the land are currently exposed!

The renderings are as follows: (for reference only, eventually the developer announced)

Sales Hotline?: 400-8123-224

According to the housing price linked hint, the Housing link price of the PDP0-0307 unit D1B-6 plot and the D1E-11 plot in Caolu Central Town, Pudong New District is 45,000/㎡, which is far lower than the average price of the surrounding second-hand housing.

Commitment

PDP0-0307 unit D1B-6 plot in Caolu Central Town, Pudong New Area, D1E-11 plot is located in Caolu Town, Pudong New District, east to Huagu Road, south to Qinjiagang Road, west to Gu Tang Road, north to north to north to north. Jin Zhaolu.

"Bright City" is a comprehensive plot of commercial and residential office

The lower limit of the residential set is 476 sets

Line 9 Gu Tang Road Station

Residential & Complexing price is 45,000 yuan/㎡

People and cities

New demonstration zone in Pudong, meet the future

Pudong has never lack of miracles. Pudong itself is a miracle. From Lujiazui in the 1990s, to the front beach planned by the 12th Five -Year Plan, and then to the Golden Bridge City Sub -center and Zhangjiang City Sub -center, Pudong’s speed represents Shanghai speed.

In 2019, Pudong New Area was given municipal economic management authority. In 2021, the "Decision on the Formation of the Pudong New District Regulations of the Shanghai People’s Congress and its Standing Committee" was adopted in 2021. By 2035, the socialist modern international University with world influence will be basically established. Urban cities.

Bright cities, Luzi World Pudong, Tangzhen-Cao Lu-Heqing City Town Cross Town Cao Lu, in the south of Zhangjiang Gao Technology Park, Biyun International Community in the west, and Gaqiao Free Trade Zone in the north. Only one outer ring line is separated from the Pudong 2035 plan. The time of the two songs can reach 2.18 million square meters of Jinqiao’s "9 palace", which has superior geographical and traffic advantages.

Project area map

Bright cities, compound development of commercial, office buildings, residential and other formats, and integrate public travel, office, entertainment, shopping and other functions one stop. At the same time, the value of surrounding land is greatly increased, and the development of the entire sector will be driven, and the future will become the core business center of the "Cao Hetang" region.

Diagram

People and life

"6D" tod, a new era of life mode

As the new generation of TOD products of China Merchants Shekou, the bright city comes with about 90,000 square meters of business -China Merchants Garden City, only 416 houses, 6 office buildings, etc., to create a three -dimensional lifestyle with the new "6D" TOD model.

At this point, home, shopping malls, office buildings, and subways have no underground pass within about 400 meters, and enjoy all supporting facilities. Easily realize the efficient and high -quality experience of work, life, social, and travel. With more comfortable travel standards, richer business scenarios, greener urban environments, more vibrant living forms, and more free living space, create a new urban model of "man -made".

Diagram

The construction surface of the "China Merchants · Bright City" residential product is about 105-135㎡, with a total of 416 units. It is expected that the first phase of the residential house will be pushed 105㎡Essence The apartment diagram is as follows:

Peripheral facilities:

【Business Resources】

There are commercial facilities such as Shanghai Jinqin Square, Baolong City Plaza, Yue Tian Di and other commercial facilities around the plot.

Baolong City Plaza

【Ecological Resources】

There are also Jinhai Wetland Park in the ecology.

Jinhai Wetland Park

The "Bright City" is about 1 kilometer of Perma Hills (real estate transformed by the dormitory). The apartment is about 41-108 square meters of 1-4 rooms, with a total price of about 2.88 million.

Peima hill sand table

The west side of the plot is the riverside urban garden project. It was completed in 2006. The current average listing price of second -hand housing is 61,000/㎡.

Riverside city garden

Everyone who loves life has a better idea for the city! As a rare subway disk in Pudong, the project has attracted much attention from the start of the land. On the day of the release of the case, many customers have been looking forward to it.

Officially released by the project,China Merchants Shekou "6D" TOD -The bright city exhibition hall is grandly opened on January 27,,The exhibition hall is located in the northeast corner of the intersection of Jinzhao Road, Gu Tang Road, about 200 meters south of McDonald’sEssence Please enter the registration channel for consultation and appointment!