社会医疗保险欺诈法律责任研究

发布时间：2018-04-16 12:12

本文选题：社会医疗保险 + 欺诈　；参考：《烟台大学》2017年硕士论文

【摘要】：经过多年的努力,我国逐步确立了覆盖全民的社会医疗保险制度。但近些年来,全国各地医保基金诈骗案频繁发生。医疗保险欺诈行为的多发,医保基金的过分负重,让我们意识到医疗保险欺诈行为必须被重视且亟需规制。文章从我国立法现状入手,分析了我国立法关于社会医疗保险欺诈的现有规定,指出立法缺陷,主要是没有专门规制社会保险欺诈行为的法律,能够作为社会医疗保险欺诈法律责任依据的法律非常有限,也缺乏问题解决的针对性。鉴于美国、英国、德国等发达国家医疗保险反欺诈法律制度的经验,结合我国实际情况,在社会医疗保险欺诈民事责任的追究上可以从建立医疗保险欺诈不当得利返还制度,在社会医疗保险服务协议中适当加入民事责任的约定,增加医疗保险欺诈惩罚性责任的适用,建立告发人诉讼制度等几方面着手;在刑事方面可以新设社会保险诈骗罪作为规制医保欺诈行为的法律依据,制定利于解决社会医疗保险欺诈犯罪法律适用问题的相关司法解释。社会医疗保险反欺诈法律制度的研究将为社会医疗保险反欺诈工作的开展提供强有力的法律依据。
[Abstract]:After years of effort , our country has gradually established the social medical insurance system covering the whole people . However , in recent years , the fraud of medical insurance funds in the whole country has frequently occurred . In the past few years , we have analyzed the existing regulations on the fraud of medical insurance fraud , and pointed out that the legislation defect , mainly the law that does not specifically regulate the social insurance fraud , can be used as the legal basis for the legal liability of social medical insurance fraud , and to set up the relevant judicial explanation for the legal application of social medical insurance fraud crime . The research of the anti - fraud legal system of social insurance medical insurance will provide a strong legal basis for the anti - fraud work of social insurance .

【学位授予单位】：烟台大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：D924.35

【参考文献】