Recently, the website of the Beijing Municipal Medical Insurance Bureau issued the "Notice on the Dynamic Management of Designated Medical Institutions in March 2025", which reported that seven designated medical institutions including Beijing Changping Huiren Hospital violated the "Beijing Medical Insurance Designated Medical Institution Service Agreement" and relevant regulations on basic medical insurance. According to the relevant terms of the "Beijing Medical Insurance Designated Medical Institution Service Agreement", the above seven designated medical institutions were given a suspension of the agreement for 6 months.

The full text is as follows:

About 6 other companies including Changping Huiren Hospital in Beijing

Notice on the decision to handle violations in designated medical institutions

Medical insurance agencies in each district, designated medical institutions, designated retail pharmacies:

During the special inspection to combat fraud and insurance fraud in 2024, six designated medical institutions including Beijing Changping Huiren Hospital were found to violate the "Beijing Medical Insurance Designated Medical Institution Service Agreement" and relevant regulations on basic medical insurance. In order to strengthen the management of designated medical institutions and maintain the safety of medical insurance funds, in accordance with the relevant terms of the "Beijing Medical Insurance Designated Medical Institution Service Agreement" and the relevant provisions of basic medical insurance, the violations and handling results of 6 medical institutions are now reported as follows:

Beijing Changping Huiren Hospital, Beijing Changping Bohua Jingkang Hospital, and Beijing Dongfangming Traditional Chinese Medicine Hospital are suspected of fabricating medical service projects to embezzle medical insurance funds. Beijing Jingda Hospital is suspected of assisting medical treatment in impersonation and interchange medical treatment projects to embezzle medical insurance funds. Beijing Chengbei Longcheng Hospital is suspected of forging medical documents to embezzle medical insurance funds. Beijing Miyun Jinghua Traditional Chinese Medicine Hospital is suspected of fabricating a traditional Chinese medicine treatment project to embezzle medical insurance funds.

After research and decision, in accordance with Article 42, Paragraph 1 of the "Interim Measures for the Management of Medical Insurance Targeted Medical Institutions" (National Medical Insurance Administration Order No. 2) and Article 104, Paragraph 33 of the "Beijing Medical Insurance Targeted Medical Institution Service Agreement" (First-level and below designated medical institutions, 2024), Beijing Changping Huiren Hospital, Beijing Changping Bohua Jingkang Hospital, Beijing Dongfangming Traditional Chinese Medicine Hospital, Beijing Jingda Hospital, Beijing Chengbei Longcheng Hospital, and Beijing Miyun Jinghua Traditional Chinese Medicine Hospital will be suspended for 6 months, and will take effect on April 30, 2025.

The medical insurance agency of Changping District, Tongzhou District and Miyun District will notify the insured persons who seek medical treatment in the above six designated medical institutions by announcement before April 30, 2025, and properly resolve the medical treatment problems of insured persons. Medical insurance agencies in each district will no longer pay the medical expenses incurred by insured persons at Beijing Changping Huiren Hospital, Beijing Changping Bohua Jingkang Hospital, Beijing Dongfangming Traditional Chinese Medicine Hospital, Beijing Jingda Hospital, Beijing Chengbei Longcheng Hospital, and Beijing Miyun Jinghua Traditional Chinese Medicine Hospital after April 30, 2025.

The violations of six designated medical institutions including Changping Huiren Hospital in Beijing resulted in losses of medical insurance funds, causing adverse effects in society, and destroying the image of designated medical institutions. All designated medical institutions in the city should take it as a warning, strictly implement all medical insurance rules and regulations, conscientiously implement basic medical insurance service agreements, cherish the honors of designated medical institutions, and prevent violations from occurring. The medical insurance management departments of each district should strengthen supervision and management of designated medical institutions in their jurisdiction to ensure that reasonable and standardized medical services are provided to insured persons.

Notice on the Decision on the Handling of Violations of Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital in Beijing Zhenghe Hospital Management Service Co., Ltd.

Medical insurance agencies in each district, designated medical institutions, designated retail pharmacies:

After investigation and verification, the Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital of Beijing Zhenghe Hospital Management Service Co., Ltd. violated the "Beijing Medical Insurance Designated Medical Institution Service Agreement" and relevant regulations on basic medical insurance. According to the relevant terms of the "Beijing Medical Insurance Designated Medical Institution Service Agreement", the violations and handling results of the Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital of Beijing Zhenghe Hospital Management Service Co., Ltd. are now reported as follows:

Beijing Zhenghe Hospital Management Service Co., Ltd. Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital has problems such as assisting others to seek medical treatment under the name, suspected of colluding with others to issue fee documents in falsehoods, and fabricating medical service projects to defraud medical insurance funds.

After research and decision, in accordance with Article 102 and Article 104, Article 27 of the "Beijing Medical Insurance Designated Medical Institution Service Agreement" (First-level and below designated medical institutions, 2024), the hospital will be given a six-month suspension of the agreement, and the illegal physicians Fu Ronghua (Medical Insurance Physician Code: D110102114997), Liang Yan (Medical Insurance Physician Code: D110115139288), and Liang Junhong (Medical Insurance Physician Code: D130824008725) will be suspended for 6 months of medical services involved in the use of medical insurance funds, effective on April 30, 2025.

The Daxing District Medical Insurance Agency will notify the insured persons who seek medical treatment at the Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital of Beijing Zhenghe Hospital Management Service Co., Ltd. by announcement before April 30, 2025, and properly resolve the medical treatment problems of insured persons. Medical insurance agencies in each district will no longer pay the medical expenses incurred by insured persons at the Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital of Beijing Zhenghe Hospital Management Service Co., Ltd. after April 30, 2025 (inclusive).

The violation of the Bone Guardian Integrated Traditional Chinese and Western Medicine Hospital of Beijing Zhenghe Hospital Management Service Co., Ltd. led to losses of medical insurance funds, causing adverse effects in society, and destroying the image of designated medical institutions. All designated medical institutions in the city should take it as a warning, strictly implement all medical insurance rules and regulations, conscientiously implement basic medical insurance service agreements, cherish the honors of designated medical institutions, and prevent violations from occurring. The medical insurance management departments of each district should strengthen supervision and management of designated medical institutions in their jurisdiction to ensure that reasonable and standardized medical services are provided to insured persons.

[Editor in charge: Sun Hui]