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为积极推进新农合基层卫生所普通门诊试点工作,某区新农合管理中心对定点基层卫生所执行了参合群众在普通门诊实行按单笔处方进行“一般诊疗费”及“药品零差价补偿”的补偿政策。审计组运用计算机审计手段对基金业务数据进行审计,发现部分卫生所存在利用政策漏洞及新农合业务信息系统功能设置缺陷,虚假录入门诊病历或对单笔处方分解用药,套取新农合基金的问题。
In order to actively promote the pilot work of general outpatient clinics of grass-roots clinics in the new rural areas, the NCMS of a certain district carried out the “general medical expenses” and “drugs” in designated clinics at the designated primary health clinics Zero difference compensation "compensation policy. The audit team used computer audit methods to audit the fund business data and found that some health clinics had exploited the loopholes in the policy and the functions of the NCMS information system to set up deficiencies. They falsely entered the out-patient medical records or used prescriptions for single prescriptions, The problem.