On October 31, 2025, the "Mobilization Meeting for Standardized Self-Discipline of Private Traditional Chinese Medicine Medical Institutions in Shanghai," organized by the Shanghai Social Medical Institutions Association, was held in the 2nd-floor conference hall of Building 4, Shanghai Tianyou Hospital. Llinks partner Mr. Yiguang Lu was invited to attend and deliver a specialized training lecture on medical insurance policies and legal regulations.
This training focused on the compliant use of medical insurance funds. Mr. Yiguang Lu elaborated across three main modules: an overview of medical insurance fund management, common grounds for medical insurance violations, and legal remedies for medical insurance disputes. Through typical cases, such as the fraudulent medical insurance claims exceeding 12 million RMB by two private Traditional Chinese Medicine (TCM) clinics in Shanghai and the case of AstraZeneca's forged medical records for fraudulent claims, Mr. Lu provided an in-depth analysis of the criteria for determining various medical insurance violations—including duplicate billing, unbundling of hospitalization, overtreatment, forging medical records, "bed-hanging" (fictitious) hospitalization, substitution, and unbundling of prescriptions—along with their legal consequences. Simultaneously, Mr. Lu explained practical legal issues regarding the handling of medical insurance disputes, such as key points for evidence submission and standardized practices for signing inquiry transcripts, helping private TCM medical institutions enhance their awareness of practicing law, standardize diagnostic and treatment behaviors, effectively prevent legal risks related to medical insurance, and promote the continuous improvement of TCM service quality.
This training closely addressed the critical compliance pain points in the medical industry, effectively helping medical institutions enhance their awareness of compliance risk prevention, and providing strong support for medical institutions to improve their compliance management systems and reduce legal risks. In the future, Llinks will continue to provide comprehensive professional legal services—including compliance training, risk auditing, and dispute resolution—to medical institutions, assisting the medical sector in achieving high-quality, compliant development.
