BEIJING — In a continued effort to safeguard public health funds, China’s National Healthcare Security Administration (NHSA) has launched a tip-off service via its official WeChat account, allowing citizens and social organizations to report suspected cases of medical insurance fraud.
The initiative, introduced in April 2025, is the latest in a series of nationwide anti-fraud campaigns targeting misuse of health insurance funds. To encourage public participation, the NHSA is offering monetary rewards for valid reports, ranging from CNY200 (approx. $27.80) to CNY200,000, based on the significance and impact of the information provided.
Emphasizing the need for collective vigilance, the NHSA stated that misuse of medical insurance funds poses a serious threat to public welfare. The agency urged citizens and social groups to actively support efforts to combat fraudulent activity in the healthcare system.
In 2024 alone, Chinese health authorities recovered approximately CNY27.5 billion in misappropriated funds, with 10,741 individuals arrested in connection with insurance fraud. Investigations led to the identification of 2,008 fraudulent institutions and 3,018 fraud cases handled in coordination with public security departments.
To further tighten oversight, the NHSA is preparing to implement a nationwide drug traceability code system. Each medication will be assigned a unique electronic identifier, enabling regulators to monitor drug distribution and detect suspicious practices such as resale, substitution, or misuse of insured medicines. This digital tracking system is also expected to help prevent the use of counterfeit prescriptions and the improper use of medical insurance cards.
Industry experts have highlighted the importance of enhancing the national medicine supply chain tracking system to ensure full transparency and accountability.
The NHSA also plans to introduce a points-based credit system for healthcare professionals who manage insurance fund claims. The system will reward compliant behavior and penalize misconduct, reinforcing ethical standards in the sector.
In a parallel move, the administration has expanded a scheme integrating pharmacies with China’s outpatient reimbursement system. This allows insured patients to be directly reimbursed for their medicine purchases at drugstores, aiming to streamline access and reduce potential for fraud at the retail level.
Together, these comprehensive measures mark a significant escalation in China’s fight against medical insurance fraud and reflect the government’s broader commitment to safeguarding public health resources.
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