最高人民检察院、国家医保局联合发布了6件依法惩治医保骗保犯罪的典型案例1。这些案例涉及定点医疗机构人员骗保、"回流药"骗保、专科医疗机构伪造诊疗项目骗保、职业骗保人骗保、虚构劳动关系骗取生育津贴、伪造住院病历骗保等多种犯罪手段1。案例涉及的人员包括医疗机构管理者、医护人员、职业骗保人等多个主体，相关人员已被依法判处从无期徒刑至有期徒刑等不同刑罚1。
具体来看，李某霆等人骗取医保基金1296万余元，其中3名主犯被判无期徒刑至有期徒刑十年不等1；陈某连等人骗取医保基金140余万元，王某坤等人销售骗保药品涉案金额1500余万元1；弋某斌等人骗取医保基金960万余元，被判有期徒刑十五年至三年不等1。另外，柴某竹等人造成医保基金损失1000余万元，被判有期徒刑十八年至一年三个月不等1；秦某贵、张某骗取生育津贴375万余元，共拨付197万余元，分别被判有期徒刑十一年和三年1；张某庆等人骗取医保基金619.79万元，被判有期徒刑十二年至二年不等1。案例涉案金额从百余万元至千余万元1，充分展现了依法惩治医保骗保犯罪的态度。
The Supreme People's Procuratorate and National Medical Insurance Bureau jointly released six typical cases of healthcare insurance fraud on August 17, 2026, demonstrating coordinated enforcement against crimes targeting medical insurance funds.1
The cases encompassed diverse fraudulent schemes perpetrated by multiple actors within the healthcare system. Medical personnel at designated healthcare institutions engaged in illicit claims, while organized criminal networks exploited pharmaceutical supply chains through the trafficking of diverted drugs. Specialized medical facilities fabricated treatment procedures to submit false claims, and professional fraudsters conducted systematic schemes targeting the insurance system.1 Additionally, individuals fabricated employment relationships to unlawfully obtain maternity benefits, and hospital records were forged to support fictitious admission claims.1
The financial scale of these offenses ranged from over one million yuan to more than ten million yuan. One case involved Li Mouding and associates defrauding the medical insurance fund of over 12.96 million yuan, with three principal defendants convicted and sentenced to life imprisonment or fixed-term imprisonment up to ten years.1 In another case, Chen Moulian and associates unlawfully obtained over 1.4 million yuan, while Wang Moukun and others involved in selling fraudulent medications caused losses exceeding 15 million yuan.1 Yi Moubin and associates defrauded the fund of over 9.6 million yuan and received sentences ranging from fifteen to three years imprisonment.1 Chai Mozhu's group caused medical insurance fund losses exceeding 10 million yuan, with sentences ranging from eighteen years to one year and three months.1 Qin Mougui and Zhang Mo illicitly obtained over 3.75 million yuan in maternity benefits, with 1.97 million yuan actually disbursed, receiving sentences of eleven and three years respectively.1 Zhang Moqing and associates defrauded the fund of 6.1979 million yuan, with sentences ranging from twelve to two years imprisonment.1
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