Recently, the National Medical Insurance Administration reported on the unannounced inspection of Wuxi Hongqiao Hospital in Jiangsu Province, and made it clear that the next step will be to guide the Jiangsu Provincial Medical Insurance Administration to conduct a comprehensive investigation in the local area. At the same time, it will organize a special action to severely crack down on fraud and insurance fraud across the country to focus on rectifying the unhealthy trends and corruption problems around the people in the medical insurance field.

On October 10, the State Drug Administration issued the "Notice on Rewarding Internal Whistleblowers on Drug and Medical Device Quality and Safety (Draft for Comments)" (hereinafter referred to as the "Reward for Reporting") for public comments. The "Reward for Reporting" clearly states that the announcement applies to reporting major violations of drug and medical device quality and safety to the drug supervision and management department, and the reward amount for reporting cases can be up to 1 million yuan. Among them, major violations refer to violations that are suspected of crimes or have been punished with administrative penalties such as orders to suspend production and business, orders to close, revoking (revoke) licenses, and large amounts of fines and confiscations in accordance with the law.

There are about 12 articles in the Drug Administration Law that involve the above-mentioned serious disposal measures, including Article 141, which mentions "giving or receiving kickbacks or other improper benefits in the purchase and sale of drugs", and "giving money or other improper benefits to the person in charge of the medical institution that uses its drugs, drug purchasing personnel, doctors, pharmacists and other relevant personnel".

The day after the Drug Administration issued the "Reward for Reporting", the State Administration for Market Regulation issued the "Compliance Guidelines for Pharmaceutical Enterprises to Prevent Commercial Bribery Risks (Draft for Comments)" (hereinafter referred to as the "Compliance Guidelines") (click to view more related content: "National Document Release! Anti-Pharmaceutical Enterprise Commercial Bribery, Prohibition of 32 Behaviors"). The "Compliance Guidelines" proposes 32 "prohibitions" and 5 "avoidances" for academic visits, receptions, discounts, allowances and commissions of pharmaceutical companies, including prohibiting the provision of travel, fitness, entertainment and other activities during business receptions, and avoiding the payment of service fees to medical and health personnel in cash or cash equivalents.

Around October 12, the Central Commission for Discipline Inspection issued a series of documents summarizing typical cases and work experiences investigated and dealt with by the Commissions for Discipline Inspection in Guangxi, Shaanxi, Sichuan and other places in the medical field. For example, in the special action launched in Guangxi this year, the local discipline inspection and supervision organs focused on violations of discipline and law such as poor supervision, abuse of power for personal gain, dereliction of duty, and interest transfer in the medical field, and thoroughly investigated clues of problems in recent years, using information technology such as big data to collect clues. The region has filed 712 cases in the medical field, punished 514 people, and transferred 36 people.

In fact, anti-corruption in the medical field has always been a long-term work of multiple departments. Last year, the issuing agency of the "Key Points for Correcting Unhealthy Trends in the Field of Medical Purchase and Sales and Medical Services" added the National Audit Office, the Ministry of Education, the State-owned Assets Supervision and Administration Commission of the State Council, the National Disease Control Bureau, and the National Drug Administration on the basis of the original nine departments, expanding to 14 departments, and continuing to this year. Among them, the audit department plays an increasingly important role. The article "Shaanxi Improves the Coordination Mechanism of Various Supervisions to Release the Superposition Effect and Improve Governance Efficiency" recently released by the Central Commission for Discipline Inspection summarizes the anti-corruption work experience of a local Commission for Discipline Inspection and Supervision in Shaanxi. It mentions that in the rectification of corruption problems in key areas such as medicine, the local Commission for Discipline Inspection and Supervision has continuously strengthened cooperation with auditing, inspection and other units, uniformly received and efficiently distributed all kinds of transferred problem clues, and implemented various supervision coordination and joint punishment for complex, difficult and policy-related and professional problem clues.

"Audit supervision starts from the source of economic business and can provide relevant evidence for discipline inspection and supervision; discipline inspection and supervision coordination auditing, accounting, statistics and other professional forces to participate deeply, can achieve complementary advantages, continuously improve the ability to discover and investigate corruption problems, and promote efficient settlement of problems." Relevant case handlers introduced that strengthening the coordination and linkage of discipline inspection and supervision and auditing and other supervision is particularly important for areas with frequent capital flows, large flows and many links. While multiple departments are joining the anti-corruption campaign in medicine, the technical means adopted by various departments are also gradually upgraded.
The Third Plenary Session of the 20th Central Commission for Discipline Inspection emphasized the need to promote the deep integration of digital technology into various discipline inspection and supervision businesses. Deepen the use of big data technology to enrich supervision methods, accurately discover and seriously investigate the "petty corruption" around the masses through supervision model early warning and data collision analysis.

In the medical field, some regions have organically combined the construction of clean hospitals with special rectification work in the medical and pharmaceutical fields, and explored the "big data + supervision" model. For example, the clean hospital big data supervision platform in Danfeng, Shaanxi Province has collected and stored various types of financial data such as outpatient charges, inpatient charges, equipment, medicine and consumables procurement of the three major public hospitals at the county level in the past three years. By building a medical industry data model, the platform can compare and analyze data, realize early detection and early warning of problem clues, and quickly, efficiently and accurately lock in key events and key people.

From the review of past cases, it can be found that violators often rely on secret operations to cover up corrupt behavior, and the use of big data can make up for the shortcomings of traditional means, realize the transformation from manual supervision to technical supervision, lock problem clues through full data entry screening, screen and compare information, and make hidden traces visible in the process of mutual verification.

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