医保基金智能监管研究综述

Summary of Research on Intelligent Supervision of Medical Insurance Fund

摘要: 医保基金是国家重大民生工程，也是百姓的“钱袋子”，更是民生之基、社会之本。然而，目前我国医保基金监管工作面临着监管力量薄弱、信息系统不完善、违规问题多、法律制度不健全等诸多问题，严重影响了医保基金的安全使用。随着信息技术和大数据等技术的发展，医保基金智能监管应运而生。本文对国内外医保基金智能监管进行了分析，为进一步完善我国医保基金智能监管体系提供建议与参考。

Abstract: The medical insurance fund is a major national livelihood project, and also a “money bag” for the people. It is also the foundation of livelihood and the foundation of society. However, at present, China’s medical insurance fund supervision work faces many problems, such as weak regulatory power, imperfect information systems, multiple violations, and imperfect legal systems, which seriously affect the safe use of medical insurance funds. With the development of information technology and big data, intelligent supervision of medical insurance funds has emerged. This article analyzes the intelligent supervision of medical insurance funds at home and abroad, providing suggestions and references for further improving the intelligent supervision system of medical insurance funds in China.