论文部分内容阅读
2008年,在对某市五项社保基金审计的过程中,笔者所在审计组积极探索信息系统审计的模式与方法,发现该市医保信息系统存在三个设计缺陷和两处设计错误,据此查出该局超限额报销医疗费用、违规报销医疗保险费、违规为全局职工办理慢性病门诊待遇、违规将未经过审批的药店确定为医保定点零售药店等违纪违规问题。
In 2008, during the process of auditing five social security funds of a certain city, the author’s audit team actively explored the modes and methods of information system auditing and found that there were three design defects and two design errors in the city’s medical insurance information system. Based on this, Out of the Bureau over limit reimbursement of medical expenses, illegal reimbursement of medical insurance premiums, irregularities for the treatment of chronic diseases outpatient services for the global workers, unlicensed non-approved pharmacies identified as Medicare designated retail pharmacies and other disciplinary violations.