英语新闻丨哈尔滨四家药店因欺诈骗保被责令停业

Four pharmacies in Harbin, capital of Heilongjiang province, have been shut down and terminated from the medical insurance system as part of an investigation into a medical insurance fraud case involving more than 10,000 falsified prescriptions, China Central Television reported on Tuesday.

10月15日，据总台央视新闻报道，因涉及伪造上万张处方欺诈骗保，黑龙江省省会哈尔滨市的四家药店医保服务协议已全部被解除，并被责令停业配合调查。

Authorities have frozen 62.23 million yuan ($8.74 million) in medical insurance funds related to the case, according to the report.

报道称，公安部门已冻结涉案医保基金6223万元（约874万美元）。

Fifty-one people have been subjected to criminal coercive measures, with 13 in criminal detention, three in administrative detention and 15 released on bail pending trial, according to authorities.

公安部门表示，已采取刑事强制措施和治安处罚共计51人，其中刑事拘留13人、行政拘留3人、取保候审15人。

The fraud case was uncovered after a data analysis by the Big Data Center of the National Healthcare Security Administration revealed unusual activity at a Harbin pharmacy. Investigators found that 96 insured individuals had made abnormally large purchases, with some spending over 1 million yuan on medications over two years, CCTV reported on Monday.

据14日总台央视新闻报道，国家医保局大数据中心筛查数据时，发现在哈尔滨市的一家药店存在异常活动，从而揭露了这起欺诈骗保案件。调查人员发现，有96名参保人从药店购买药品金额特别巨大，一名参保人两年间购买的药品金额甚至超过了百万元。

The investigation focused on excessive purchases of Suke Xin, also known as Doptelet (avatrombopag) tablets, a medication prescribed for short-term use to treat liver disease. One patient reportedly purchased 2,400 tablets — far exceeding the clinically recommended dosage — and consumed them over 800 days, spending more than 1 million yuan.

调查的重点是苏可欣的过量购买，该药品名为马来酸阿伐曲泊帕片，简称阿伐曲泊帕，是一种用于短期治疗肝病的处方药。据报道，一名患者购买了2400片阿伐曲泊帕，金额超过百万元，共服用800天，远超临床合理用量。

Medications like Doptelet are classified as "special drugs" that are used to treat specific conditions and require strict documentation, including prescriptions, during sales to prevent fraud. However, the patient's son admitted to purchasing the medication without providing a prescription.

像阿伐曲泊帕这样的药品被归类为“特殊药品”，用于治疗特殊疾病，在销售过程中需要处方等严格的文件记录，以防止欺诈行为。然而，患者的儿子承认在没有提供处方的情况下购买了药物。

"Every time I went to the pharmacy, they gave me medications for three months," he said.

患者儿子说：“每次我去药店，他们都会给我开三个月的药。”

Further investigation into the pharmacy and three others revealed widespread use of fraudulent handwritten prescriptions, many of which were purportedly from institutions such as the Harbin Medical University Cancer Hospital, even though the hospital had stopped giving handwritten prescriptions long ago.

对该药房和其他三家药房的进一步调查显示，手写处方造假的现象十分普遍，其中许多处方标注来自哈尔滨医科大学附属肿瘤医院等医疗机构，尽管该医院早已停止开具手写处方。

Investigators also discovered prescription books at one pharmacy filled with consistent handwriting, despite being signed by various doctors.

调查人员还在一家药店发现了手写处方本，尽管有不同医生的签章，但上面的字迹却都出自一个人。

One pharmacy manager admitted that the fraudulent prescriptions were provided by a pharmaceutical representative, while another pharmacist confessed to purchasing prescriptions online and processing them.

一位药店负责人承认，虚假处方是由一名药品的医药代表提供，而另一位执业药师也坦白处方是从网上购买后再行加工的。

Some customers told the inspection team they had bought prescription drugs at inflated prices for years without needing to present a prescription. As a result, the National Healthcare Security Administration handed over case details to local public security authorities.

一些患者告诉检查组，他们多年来购买这些高额处方药，并不需要提供处方。目前，国家医保局已将案件详情移交当地公安机关。

An expert cited by CCTV said that problems such as fake medical treatments, resales of drugs covered by insurance and people cashing out medical insurance funds have long plagued regulators, and stricter oversight is needed.

央视援引一位专家的介绍，虚假就医、医保药品倒卖、医保套现等问题长期困扰着监管部门，对医保基金监管提出了更高的要求。

In response, the administration announced plans on Monday to recruit 20 social supervisors to enhance the supervision of medical insurance funds. Their role will be to monitor the use of funds by designated medical institutions and insured individuals, reporting any irregularities or illegal activities.

为此，国家医保局14日宣布拟选聘20名社会监督员，以加强医疗保障基金监督。他们的职责是对定点医药机构及参保人员使用医保基金情况进行监督，发现并反馈任何违规或违法行为。

"The goal is to strengthen social oversight and mobilize broader participation in safeguarding the security of medical insurance funds," the administration said in a statement.

国家医保局在公告中表示：“目的是强化社会监督作用，更好动员社会各界参与医疗保障基金监督，切实维护基金安全。”

falsify

v. 伪造；篡改

fraudulent

adj. 欺骗的，不诚实的

plague

v. 困扰，折磨

medical insurance funds

医疗保障基金