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Zhuhai City Social Security Anti-Fraud Measures

Original Language Title: 珠海市社会保险反欺诈办法

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(Act No. 51 of the People's Government Order No. 51 of 6 January 2006, 23 December 2015

Amendments to the 870th ordinary meeting of the People's Government of the jewell City

Chapter I General

Article 1 provides for regulating social insurance anti-fraud, redressing and investigating social insurance fraud, guaranteeing the security of the Social Insurance Fund, safeguarding the legitimate rights and interests of the insured person, and developing this approach in line with the relevant legislation such as the People's Republic of China Social Insurance Act.

Article II applies to social insurance anti-fraud efforts within the city's administration.

Article 3 of this approach refers to the fact that citizens, legal persons or other organizations are involved in social insurance, payment of social insurance contributions, social insurance treatment or social insurance management services, and to the concealment of truth.

This approach refers to the protection and investigation of social insurance fraud by the social security administrative authorities and the relevant administration.

This approach refers to the social insurance anti-fraud work sector, which refers to the social security administrative authorities and the related administration.

This approach refers to the social insurance anti-fraud staff, which is qualified by administrative law enforcement in the social insurance anti-fraud service.

Article IV. The municipal social security administration is the competent authority for the entire municipal social insurance anti-fraud.

The authorities, such as public security, civil affairs, business, tax, health, finance, medicinal, silver, custodian, servitude, etc., assist in the process of social insurance anti-fraud within their respective responsibilities.

Article 5 Social insurance anti-fraud persists in the prevention and investigation and follows the principles of objectivity, impartiality, legitimacy, integrity and efficiency.

Article 6. The municipal social security administration authorities should establish a robust social insurance credit record system that incorporates the information generated by the social insurance anti-fraud work in a timely manner into the credit information-sharing platform.

The requirements for social insurance anti-fraud work are included in the same fiscal budget.

Article 8. Any organization or person has the right to monitor violations of social insurance laws, regulations and regulations. The reporting is true and provides incentives for the identification of reportingers of major violations of social security laws, regulations or regulations.

Specific criteria for incentives are developed by the municipal social security administration authorities, together with the municipal financial sector, in accordance with the economic and social development of the city.

Chapter II

Article 9 contains one of the following acts in the course of the collection of social insurance contributions:

(i) Contrary or alter the registration material of social insurance.

(ii) Besieged or concealed information on the use of work, pay or other information.

(iii) Fering, changing or deliberately destroying books, materials related to social security.

(iv) Restructuring labour relations by means of proof of material such as falsification, mutation of wages statements, providing false evidence, validating opinions or other hypothetical social insurance conditions, participating in social insurance or receiving social insurance treatment.

Article 10

(i) Stimulating or changing age, age of work, special working materials, medical information, etc. in advance of the receipt of old-age insurance treatment or increasing the age of contribution.

(ii) Contrarying, changing archives, making false material, false statements, concealing personal and unit information or acting in others, receive old insurance treatment or leading to fund expenditure.

(iii) Excluding the loss of treatment, such as death or imprisonment, and receiving old-age insurance treatment.

Article 11. Medical, maternity insurance payments are one of the following acts:

(i) Required identification, social security card transfers for medical treatment and the use of integrated funds.

(ii) Contrary, intrusive identification or social security cards, and use integrated funds.

(iii) Exhibition, manufacture history, falsification, conversion of medical information, tickets or use of false medical information, instruments, etc., medical, maternity insurance treatment or financial expenses.

Article 12

(i) A person, time, place, place, cause, falsification or modification of the material, affecting the identification of work injury or the identification of labour capacity.

(ii) Constraints, collusion history or falsification, conversion of medical information, tickets, etc., the treatment and cost-of-living conditions for mallious insurance, treatment of work injury insurance or resulting in fund expenditure.

(iii) Concluding the loss of the conditions for the treatment of work injury insurance, the treatment of work injury insurance or the resulting expenditure of the Fund.

(iv) In the case of workers and injured persons, medical, equipped and supporting equipment is available.

Article 13 presents one of the following acts in relation to unemployment insurance payments:

(i) Constrainting or adapting related evidence materials, enjoying unemployment insurance treatment or leading to fund expenditure.

(ii) Concluding the loss of access to unemployment insurance, the treatment of unemployment insurance or the resulting expenditure of the Fund.

Article 14. Social insurance services such as medical institutions, pharmaceutical operators and their staff are the following acts:

(i) Provision of material vouchers such as false disease diagnosis certificates, sickness, reporting, prescription or medical bills.

(ii) Removal or borrowing from the medical insurance service terminals for the medical insurance fund.

(iii) The introduction of medical, industrial injury or maternity insurance funds by a social insurance service agency.

(iv) Acknowledge or induce a non-combatant to take possession of medical, auxiliary equipment, etc. and be settled on behalf of the insured person.

(v) Provide non-necessary and unreasonable medical services to the insured person.

(vi) To assist the insured person or to collect the social insurance information retreat of the insured person on medical information, tickets, etc., to extract medical care, work injury or maternity insurance funds.

(vii) Projections to be converted from the pool of insured persons to the Integrated Fund.

(viii) The non-implementation of the provisions of relevant laws and regulations, such as health, medicines, prices, resulting in the loss of medical, industrial or maternity insurance funds.

Chapter III

Article 15. The Social Insurance Administration performs the following anti-fraud duties:

(i) Reports of social insurance fraud and complaints.

(ii) The identification of major cases of fraud in social security.

(iii) Incentives.

(iv) Other anti-fraud responsibilities under social insurance laws, regulations and regulations.

Article 16 performs the following anti-fraud duties by the labour security inspectorate:

(i) Reports of social insurance fraud and complaints.

(ii) Investigation and processing of social insurance fraud.

(iii) The transfer of fraud cases to be handled by other administrations.

Article 17

(i) Reports of social insurance fraud and complaints.

(ii) A service agreement with social insurance services such as medical institutions, pharmaceutical operators, and is administered by law.

(iii) Verification of the payment of social insurance contributions and the treatment of social insurance.

(iv) The transfer of social insurance administrative authorities in cases of suspected fraud.

Article 18

(i) To receive reports of social insurance fraud and complaints from social insurance contributions.

(ii) Approval of projects such as the contributions base, the number of contributions and the number of contributions, for example, for the benefit of the agent's unit and personal social insurance.

(iii) A review of the failure of the user unit to provide for insurance, declaration and payment of social insurance.

(iv) Provide data and information related to social insurance anti-fraud to the social security administration authorities on a regular or dedicated basis.

Article 19 Public security authorities should share information on the birth, death and the registration, relocation and write-off of persons, with social insurance agencies, social insurance premiums.

The competent authorities, such as the business, civil affairs and the development of institutions, should register licences and credit information platforms in a timely manner for the establishment of a unit of the user, the termination of the jewell City business subject matter, and make them public.

The burial management provides monthly information on the list of deaths and identification numbers to social insurance institutions; monthly information on the loss of access to social insurance treatment by the Government of the Town, the Social Security Service of the Street Office shall be provided to the social insurance agencies, the Resident Council, the Collective Economic Organization of the Village and medical institutions.

Article 21, the authorities, such as social security, health, finance, audit and social insurance agencies, social insurance insurance agencies should be treated in accordance with the law on reports and complaints that fall within the scope of the duties of this sector, this body shall be transferred within five working days to the sectors, institutions that are entitled to be dealt with. Departments, institutions that are entitled to be dealt with in a timely manner shall not be construed.

Section II of the Social Insurance Anti-Fraud Department's case of alleged fraud should be investigated by law.

Article 23 of the Social Insurance Anti-Fraud Department is responsible for suspected fraud cases and should be closed within 60 working days from the date of the complaint. The situation is complex, with the approval of 30 working days by the head of the social insurance anti-fraud service.

The duration of the case set out in the previous paragraph shall not be taken into account in order to ascertain the facts and the time of the audit.

Article 24 of the Social Insurance Anti-Fraud Department conducts investigations, inspections and inspections, the inspectorate and the individual should provide information on social insurance in practice without denying or concealing reports.

Article 25 When the social insurance anti-fraud service performs its duties, the following measures may be taken by law:

(i) Access to the relevant premises to conduct investigations, inspections and inspections in the form of a clear or implicit visit.

(ii) Records, photographs, videos, videos or references, replication of information, which may be transferred, concealed or lost.

(iii) Inquired units and individuals related to investigations, inspection matters, requesting clarifications and information on the relevant issues.

(iv) To put an end to and responsibly the acts of concealment, falsification, conversion or destruction of relevant documentation information, financial statements.

(v) Authorize third parties to investigate and conduct specific audits.

(vi) Other measures under laws, regulations and regulations.

Article 26 After the investigation of the social insurance anti-fraud sector, the referral of cases to other government functions should be transferred in a timely manner, in accordance with the relevant provisions.

Cases of suspected crimes should be transferred by law to public security authorities.

Chapter IV Preventive regime

Article 27 authorities such as social insurance, rehabilitation, public safety, civil affairs, business, tax, health, finance, food pharmacies, banks, custodial authorities should share resources on relevant operational data for social insurance.

Article 28 agencies charged with social insurance, the social insurance agencies, the financial agencies of the Social Insurance Fund, the social insurance service agencies should establish a robust internal control system to prevent the risk of social insurance fraud.

Article 29 of the Social Insurance Insurance Insurance Insurance Agency, the Social Insurance Fund's Financial Excluding Authority, the Social Insurance Fund's Bank of Social Insurance, the Social Insurance Services Agency shall transmit the relevant data on the last month's social insurance management to the Social Insurance Administration's Monitoring Information System by the date.

When the Social Insurance Agency enters into a position-point service agreement with the social insurance service agencies, it should be agreed that the Social Insurance Service regularly sends information such as medical treatment projects related to the Social Insurance Fund and the management of medical materials, financial management, medical care and medical management.

The Social Insurance Anti-Fraud Department should track, analyse and assess the problems identified and conduct on-site inspections or case surveys.

All sectors, agencies should communicate to the social security administrative authorities on a timely basis reports of complaints and treatment and punishment involving social insurance fraud.

Article 33 The Social Insurance Agency shall publish to society information on its participation in social insurance and on the income, expenditure, balances and benefits of the Social Insurance Fund, as well as public social insurance guidelines and operational protocols, in accordance with the law.

The user unit shall publish the payment of the full-year social insurance contributions to this unit annually to the employee of the unit.

Article 31 loses the conditions for social insurance treatment and the insured person or his or her close family shall report to the Social Insurance Agency on the change of the insured person within thirty days.

Article 32 of the Social Insurance Administration should establish the Social Security Proclamation Architecture, record, demonstration of misconceptions, and be incorporated into the public credit information management system in the city of jewell.

The relevant sectors should keep the society regularly informed of the treatment of cases of social security violations.

Chapter V Legal responsibility

Article 33, whereby one of the acts listed in article 9, paragraphs 1, 2, 3 and 3 of this approach is restructured by the Social Insurance Administrative Authority, which is not later commuted, is fined up to three times the amount of social insurance to be paid by the relevant executive branch and subject to a fine of more than two thousand dollars of the person responsible for it directly.

Articles 344, 10 to 14 of this approach are reproduced by the Social Insurance Administration, the social insurance premiums, or by the agency responsible for social insurance, and addressed the following:

(i) In the case of fraud in social security eligibility, the social insurance agencies revoke their unlawful eligibility to participate in the insurance, terminate their social insurance relations, and assist the social insurance premium agencies in identifying eligibility for social insurance.

(ii) To deceive the social security entitlements, the social insurance agencies are exempted from their unlawful social insurance entitlements.

(iii) In the case of fraud but not the loss of the Social Insurance Fund, a fine of up to three thousand dollars for the unit could be imposed on the individual, depending on the circumstances.

(iv) In the case of fraud in the treatment of social insurance or funds, the social insurance administrative authorities are responsible for releasing the social insurance pension, which takes up a fine of more than five times the amount; the refusal to return or pay a fine may apply to the People's Court for enforcement; the alleged offence is transferred to the judiciary by law.

(v) It is a social security service agency to lift service agreements. The competent and other direct responsibilities that are directly responsible for the performance of the profession are recommended by the Social Insurance Administration authorities to grant their qualifications to the competent authorities in the performance of their occupation by devoting them in accordance with the law;

Article XV of the Social Insurance Administration and other relevant departments and staff members have one of the following acts, which are being restructured by the inspection department and disposed of in accordance with the relevant provisions; Liability under the law for the Social Insurance Fund, the user unit or the individual's loss:

(i) Non-compliance with the law and gravely affect the work of the Social Insurance Anti-Fraud Survey.

(ii) Abuse of mandates, misappropriation, negligence and favouring private fraud.

(iii) Disclosure of information or privacy that is known to the identification units and individuals in the performance of their duties.

(iv) Disclosure of information affecting the proper conduct of the investigation or reprisals against the reporting person.

(v) The failure to implement a system of avoidance has resulted in a lack of justice in the conduct of investigations.

Article 36 consists of one of the following acts by a person unit and a person, which is being corrected by an order of responsibility of the social security administration, with a fine of more than two thousand dollars:

(i) There is no reasonable resistance, obstruction and obstruction of the investigation of anti-fraud staff.

(ii) To deny and delay information on fraud matters.

(iii) Discribe or conceal, destroy evidence.

Article 37 is not a matter of law, resigned by a person or dismissed a labour contract by a social security administrative order; combating reprisals, false reportings, complainants and their relatives constitute a violation of the provisions of the security administration, which is punishable by law by the public security authority.

Annex VI

Article 338 was implemented effective 1 March 2016.