The National Medical Insurance Bureau's special campaign continues to crack down on illegal chains involved in "reflow drugs."

Xinhua News Agency, Beijing, April 2 (reporters Xu Penghang and Peng Yunjia) On April 2, the reporter learned from the National Healthcare Security Administration that the Office of the National Healthcare Security Administration recently issued the “Notice on Launching a Special Campaign to Thoroughly Crack Down on Illegal and Irregular Issues in the Healthcare Insurance Drug Sector.” It has been clarified that starting in April 2026, with drug traceability code-related suspicious lead verification as the starting point, a further deepening of the special campaign to crack down on illegal and irregular issues in the healthcare insurance drug sector will continue nationwide.

It is reported that the special campaign is divided into two phases: the first phase is from April to July 2026, and the second phase is from September to November 2026. In early April 2026 and early September 2026, respectively, the National Healthcare Security Administration will issue a batch of suspicious leads related to repeated settlement of drug traceability code.

Local healthcare security departments, together with relevant departments, will coordinate national-issued leads, local leads of prescribing beyond quantity, and leads from public reports and complaints, among others. They will conduct in-depth verification and rectification and precisely crack down on illegal and irregular issues such as trafficking and reselling healthcare insurance “return-flow drugs,” swapping healthcare insurance drugs, “charging off” and “swiping” healthcare insurance credentials fraudulently, forging prescriptions, accumulating cash register captures for purchasing drugs, and consumption spikes at year-end, and promptly recover losses of healthcare insurance funds.

In addition, depending on the severity of the circumstances, they will adopt measures such as conducting interviews and reminders, requiring rectification within a specified time limit, suspending healthcare insurance settlement, terminating service agreements, implementing point-based credit management for healthcare insurance payment qualifications, and transferring the cases to competent industry authorities, judicial authorities, and discipline inspection and supervision bodies, among others.

The notice emphasizes that focusing on every link and the entire process of trafficking and reselling “return-flow drugs,” efforts will continue to strengthen a “penetration-based” crackdown on all types of implicated entities, including professional prescribers, drug peddlers, and illegal and irregular wholesale drug enterprises, as well as pharmaceutical and medical institutions, to completely sever the illegal chain of “prescribing drugs—trafficking and reselling—return-flow—sales.”

Healthcare security departments will work with relevant departments to carry out joint inspections and joint disciplinary actions, to strictly prevent healthcare insurance “return-flow drugs” from flowing to non-healthcare-insurance-designated pharmaceutical and medical institutions, online drug-selling platforms, or from being sold again in the form of out-of-pocket self-payment.

(Editor: Wen Jing)

Keywords:

                                                            Healthcare Security Administration
                                                            Drugs