On April 3, 2026, Llinks partner Mr. Yiguang Lu, who holds the professional designation of Level-1 Lawyer and has been honored as an 'Oriental Distinguished Lawyer' was invited by the Jiangxi Association of Non-public Medical Institutions to deliver a specialized lecture titled "Risk Prevention, Crisis Resolution, and Operational Assurance: Prevention and Emergency Response for Major Medical Insurance Legal Risks" at the "Jiangxi Non-public Hospital President Management Capability Enhancement Training Program." Leveraging his deep professional accumulation in the medical and insurance sectors, Mr. Lu provided participants with a presentation that combined theoretical depth with practical value, helping relevant entities of designated medical institutions build a robust medical insurance compliance defense line.
In this lecture, Mr. Lu elaborated on three core modules: the new landscape of medical insurance supervision, risk identification and prevention, and the handling of major legal risks.
Firstly, regarding the new landscape of medical insurance supervision, Mr. Lu analyzed the current high-pressure environment characterized by "full coverage of unannounced inspections, normalization of intelligent supervision, persistence of specialized crackdowns, and strictness in accountability," combined with typical cases. He also interpreted the trends in medical insurance regulatory case data and fund recovery amounts from 2023 to 2025, clearly demonstrating the importance and urgency of medical insurance compliance.
Secondly, in the risk identification and prevention segment, Mr. Lu outlined five core categories of medical insurance risks: fee management, diagnostic and treatment behavior, drugs and consumables, medical record management, and information systems. He introduced risk identification methods such as automated system screening, targeted manual sampling, and regular self-inspection and self-correction. He analyzed specific identification challenges in practice, such as forging medical records, inducing fraudulent medical treatment, excessive treatment, and "bed-staying" hospitalization, using specific cases. Simultaneously, he provided a practical path for constructing a medical insurance compliance prevention and control system from four dimensions: organizational responsibility systems, internal management rules, personnel training and culture, and normalized self-inspection.
Thirdly, regarding the handling of major legal risks, Mr. Lu focused on four major categories: medical insurance agreement disputes, administrative penalties, criminal liability, and credit evaluation. Referencing the Regulations on the Supervision and Administration of the Use of Healthcare Security Funds and other relevant laws, Mr. Lu clarified response procedures and legal bases for various risks, providing participants with full-process guidance—from communication and coordination to hearings, reviews, and litigation responses.
In conclusion, Mr. Lu emphasized that medical insurance supervision has entered a stage of intelligence, normalization, and high pressure. Relevant entities must focus on key links to accurately identify risks, build a full-process compliance system, and establish emergency plans for rapid response to achieve steady development through compliance. This lecture addressed the pain points and difficulties in medical insurance practice with detailed content, vivid cases, and clear guidance. It effectively enhanced the compliance awareness and risk-handling capabilities of attendees, providing a professional reference and practical path for designated medical institutions to standardize the use of insurance funds and mitigate major legal risks.
Mr. Yiguang Lu has long specialized in compliance management and dispute resolution in the medical insurance sector. His core practice includes:
Participating in the construction of compliance systems and self-correction for designated medical institutions;
Providing legal opinions on medical insurance compliance;
Handling disputes regarding medical insurance agreements, including signing, performance, modification, suspension, and termination;
Handling administrative penalty disputes, and representing clients in hearings, reviews, and litigation;
Handling criminal cases and defending suspects and defendants.
Mr. Lu serves as a legal advisor to numerous medical institutions, pharmaceutical companies, government departments, and enforcement agencies. Mr. Lu has represented cases involving administrative penalties and criminal liabilities for Wuxi Hongqiao Hospital, Shangrao Shenkang Hospital, and many others.
Mr. Lu is the author of Legal Risk Management Practice for Medical Institutions and Pharmaceutical Enterprises and Analysis of Typical Medical Compliance Cases, and he organized the drafting of the Operational Guidelines for Lawyers in Medical Insurance Administrative Penalty Cases.
In 2023, Mr. Lu was awarded the title of "Oriental Distinguished Lawyer". In 2025, Mr. Lu was recognized as highly recommended lawyer in the field of healthcare and life sciences by several international legal rating agencies (such as LEGALBAND, The Legal 500 Asia Pacific, etc.).
