{
  "format": "audit-dossier-v1",
  "generated_at": "2026-06-21T08:27:30Z",
  "question": "医保基金监管中哪些行为属于重点风险？ 需要补充核验哪些原始凭证？ 需要补充核验哪些原始凭证？ 的适用条件和例外情况是什么？ 需要补充核验哪些原始凭证？ 需要补充核验哪些原始凭证？",
  "answer": "问题：医保基金监管中哪些行为属于重点风险？ 需要补充核验哪些原始凭证？ 需要补充核验哪些原始凭证？ 的适用条件和例外情况是什么？ 需要补充核验哪些原始凭证？ 需要补充核验哪些原始凭证？\n当前回答由检索依据直接组成，未生成无引用结论。\n法规依据：\n- …门应当建立健全医疗保障信息系统，对定点医药机构的医保基金使用情况实行事前提醒、事中监控、事后审核的全程监督管理。 第十五条 县级以上人民政府医疗保障行政部门可以聘请会计师事务所等非直接利益相关… [C1]",
  "confidence": "medium",
  "confidence_label": "中",
  "fallback_used": true,
  "fallback_label": "检索直出",
  "review_gate": "可进入人工复核",
  "review_notice": "该导出为审计线索和人工复核底稿，不替代正式审计结论。",
  "review_checklist": [
    "核对引用片段是否完整覆盖问题。",
    "打开原文确认条款上下文。",
    "检查目录、规则、法规版本是否适用。",
    "确认是否还需 HIS 原始凭证补证。"
  ],
  "source_collections": [],
  "citation_count": 1,
  "basis_group_count": 1,
  "basis_groups": [
    {
      "evidence_type": "legal_basis",
      "title": "法规依据",
      "items": [
        {
          "citation_id": "C1",
          "chunk_id": "fa2b6835-2234-551f-8b16-7f075f56da12",
          "snippet": "…门应当建立健全医疗保障信息系统，对定点医药机构的医保基金使用情况实行事前提醒、事中监控、事后审核的全程监督管理。 第十五条 县级以上人民政府医疗保障行政部门可以聘请会计师事务所等非直接利益相关…",
          "preview_url": "http://audit.lute-tlz-dddd.top/pages/preview/fa2b6835-2234-551f-8b16-7f075f56da12",
          "locator": {
            "type": "law-preamble",
            "line_end": 9,
            "line_start": 1,
            "title_path": [],
            "page_number": null,
            "source_path": "全量法律/国家规章平台文档/山西省医疗保障基金使用监督管理办法.md",
            "window_count": 2,
            "window_index": 1,
            "article_number": null,
            "parent_article_number": null
          },
          "index_version_key": "incremental-20260615-national-regulation-stable-20260615103344",
          "source_package_version_key": "source-package-national-regulation-stable-incremental-20260615103344"
        }
      ]
    }
  ],
  "citations": [
    {
      "citation_id": "C1",
      "marker": "[C1]",
      "evidence_type": "legal_basis",
      "source_collection": "medical-insurance-laws",
      "chunk_id": "fa2b6835-2234-551f-8b16-7f075f56da12",
      "snippet": "…门应当建立健全医疗保障信息系统，对定点医药机构的医保基金使用情况实行事前提醒、事中监控、事后审核的全程监督管理。 第十五条 县级以上人民政府医疗保障行政部门可以聘请会计师事务所等非直接利益相关…",
      "preview_url": "http://audit.lute-tlz-dddd.top/pages/preview/fa2b6835-2234-551f-8b16-7f075f56da12",
      "locator": {
        "type": "law-preamble",
        "line_end": 9,
        "line_start": 1,
        "title_path": [],
        "page_number": null,
        "source_path": "全量法律/国家规章平台文档/山西省医疗保障基金使用监督管理办法.md",
        "window_count": 2,
        "window_index": 1,
        "article_number": null,
        "parent_article_number": null
      },
      "index_version_key": "incremental-20260615-national-regulation-stable-20260615103344",
      "source_package_version_key": "source-package-national-regulation-stable-incremental-20260615103344",
      "score": 0.6120109835775887,
      "metadata": {
        "locator": {
          "type": "law-preamble",
          "line_end": 9,
          "line_start": 1,
          "title_path": [],
          "page_number": null,
          "source_path": "全量法律/国家规章平台文档/山西省医疗保障基金使用监督管理办法.md",
          "window_count": 2,
          "window_index": 1,
          "article_number": null,
          "parent_article_number": null
        },
        "line_end": 9,
        "line_start": 1,
        "row_number": null,
        "sheet_name": null,
        "title_path": [],
        "is_windowed": true,
        "page_number": null,
        "source_path": "全量法律/国家规章平台文档/山西省医疗保障基金使用监督管理办法.md",
        "article_number": null,
        "index_version_key": "incremental-20260615-national-regulation-stable-20260615103344",
        "source_collection": "medical-insurance-laws",
        "source_package_version_key": "source-package-national-regulation-stable-incremental-20260615103344"
      }
    }
  ]
}