(1) Paragraph 2, Paragraph 3, Paragraph 4 and Paragraph 5 of Article 5 are amended as: "The medical insurance agency shall be responsible for the specific business work such as the registration of basic medical insurance, the verification of payment amount and the payment of benefits, and shall, jointly with the tax authorities (hereinafter referred to as the medical insurance premium collection agency), prepare the draft budget and final accounts of the basic medical insurance fund, and submit them to the medical insurance administrative department at the same level for review and summary.

"Medical insurance fee collection agencies responsible for the collection of basic medical insurance premiums.

"The financial department is responsible for the formulation, supervision and inspection of the basic medical insurance related financial accounting management system, responsible for the management of the basic medical insurance financial accounts, and reviewing and summarizing the draft budget and final accounts of the basic medical insurance fund.

"The departments of human resources and social security, health, drug supervision and administration shall, in accordance with their respective responsibilities, coordinate in the management of basic medical insurance."

(2) Paragraph 2 of Article 8 is amended as: "If the total monthly salary of employees of the employing unit exceeds 300% of the average monthly salary of employees in the whole province in the previous year, the employing unit and its employees will no longer pay the basic medical insurance premium."

(3) Article 9 is amended as: "Unemployed persons participate in basic medical insurance for employees during the period of receiving unemployment insurance benefits, and the rate is the sum of the payment rates of employers and employees. The basic medical insurance premium payable is paid from the unemployment insurance fund, and individuals do not pay the basic medical insurance premium. The specific standard of the payment base is decided by the provincial people's government. "

(4) Paragraphs 1 and 3 of Article 17 are merged into the first paragraph, which is amended as: "All the basic medical insurance premiums paid by employers for employees are included in the overall fund. The basic medical insurance premiums paid by the employees of the employer are all included in the personal account. "

The second paragraph is amended as "the part of the basic medical insurance premium paid by the unemployment insurance fund for the unemployed shall be included in the overall fund;" Personal contributions paid for the unemployed are all included in the individual accounts of the unemployed. "

One paragraph is added as the fourth paragraph: "The individual account funds of retirees shall be allocated by the overall fund in a fixed amount according to relevant regulations."

(5) Amend Article 21 to read: "The medical security agency shall establish basic medical insurance files for the insured."

(six) the fourth paragraph of Article 24 is amended as: "The insured shall enjoy the corresponding basic medical insurance benefits from the date of handling the insurance formalities and paying the basic medical insurance premium. The specific standards shall be formulated by the provincial medical security administrative department in conjunction with the provincial financial department. "

(VII) Article 25 is amended as: "Personal accounts are used to pay the expenses borne by the insured and their spouses, parents and children for medical treatment in designated medical institutions or for purchasing medicines, medical devices and medical consumables in designated retail pharmacies and other expenses stipulated by the provincial people's government.

"The administrative measures for the use of personal accounts shall be formulated by the provincial medical security administrative department in conjunction with the provincial financial department."

(8) Paragraph 1 of Article 26 is amended as: "The insured shall be hospitalized in general outpatient clinics, chronic special disease outpatient clinics and designated medical institutions, and the Qifubiaozhun and the annual maximum payment limit shall be implemented. In Qifubiaozhun year, more than 80% of outpatient chronic special diseases and hospitalization medical expenses are paid by the overall fund, and a certain proportion is borne by individuals. Qifubiaozhun annual maximum payment limit above the general outpatient medical expenses, by pooling funds to pay more than 50%, a certain proportion of personal burden. The proportion of personal burden is determined according to the insurance period of different levels of medical institutions and insured persons. For multiple general outpatient clinics, outpatient chronic special diseases and hospitalization within one year, the Qifubiaozhun is calculated cumulatively. "

(9) Paragraph 1 of Article 30 is amended as: "If an employer should participate in the basic medical insurance, but fails to participate or stops paying the basic medical insurance premium after participating, the basic medical insurance benefits that its employees should enjoy shall be borne or supplemented by the employer."

(10) Article 31 is amended as: "The provincial medical security administrative department shall, in accordance with the relevant provisions of the state, jointly with the departments of human resources and social security, finance, health and drug supervision and administration, determine the basic medical insurance drug list, medical consumables list, diagnosis and treatment project list and the scope of medical service facilities.

"In accordance with the provisions of the state should increase the proportion of personal payment of basic medical insurance special treatment items and class B drugs, by the provincial medical security administrative department in conjunction with the human resources and social security, finance and other departments according to the local basic medical insurance fund payment, the insured person's affordability to determine the specific proportion of personal payment.

"The matters specified in the first and second paragraphs of this article shall be announced to the public. The use of drugs, medical consumables, diagnosis and treatment projects, medical service facilities and fees exceeding the payment standard that are not included in the basic medical insurance coverage will not be paid by the overall fund. "

(11) Paragraph 1 of Article 33 is amended as: "If the insured person needs to be treated in a designated medical institution in a different place, he shall file with the medical security agency in the insured place according to the regulations, and the basic medical insurance benefits he enjoys shall be implemented in accordance with these regulations."

(12) Paragraph 1 of Article 34 is amended as: "The following medical expenses are not included in the payment scope of the basic medical insurance fund:

"(a) shall be paid by the industrial injury insurance fund;

"(two) shall be borne by a third party;

"(three) shall be borne by public health;

"(4) Going abroad for medical treatment;

"(5) Other expenses not paid by the basic medical insurance fund as stipulated by the state."

One paragraph is added as the second paragraph: "The provincial people's government may timely adjust the payment scope that is not included in the basic medical insurance fund in accordance with state regulations."

(XIII) Article 36 is amended as: "Local medical security agencies shall sign medical security service agreements with qualified medical institutions in accordance with the principles of integrating traditional Chinese and western medicine, giving consideration to community, specialized and comprehensive medical institutions, and facilitating the insured to seek medical treatment, in accordance with the Administrative Measures for Designated Medical Institutions and other relevant regulations, clarify their respective responsibilities, rights and obligations, implement dynamic management, and announce them to the public."

(XIV) Article 37 is amended as: "When the insured goes to a designated medical institution for medical treatment or purchases medicines, medical devices and medical consumables, the designated medical institution must inform the insured whether the relevant medical services belong to the basic medical insurance coverage, and inform the details of the charges."

(XV) Article 39 is amended as: "Medical insurance agencies and designated medical institutions shall not refuse to provide medical services to the insured in violation of the provisions of these Regulations, shall not require the insured to pay the expenses that should be paid by the overall fund, and shall not provide self-funded drugs and medical services beyond the scope of payment of the basic medical insurance fund against the true wishes of the insured.

"Medical security institutions in violation of the provisions of the preceding paragraph shall be corrected by the administrative department of medical security; If a designated medical institution violates the provisions of the preceding paragraph, the medical security institution has the right to directly deduct the settlement fee of the designated medical institution to compensate the medical expenses paid by the insured. "

(16) Paragraph 1 of Article 41 is amended as: "The administrative department of medical security and the medical security agency have the right to inspect the implementation of the basic medical insurance provisions by designated medical institutions in the process of diagnosis, inspection, treatment, drug supply and charging; Have the right to review medical prescriptions (doctor's orders), diagnosis and treatment reports, medical records, expense receipts and other related materials before paying medical expenses. When necessary, the health, drug supervision and administration departments shall provide assistance. "

(seventeen) by deleting forty-second.

(XVIII) Change Article 43 into Article 42 and amend it to read: "Employers and individuals have the right to supervise the collection of basic medical insurance premiums by medical insurance premium collection agencies and the basic medical insurance of medical insurance handling agencies; Have the right to apply for administrative reconsideration or bring a lawsuit against the basic medical insurance disputes related to units or individuals according to law. "

(XIX) Article 46 is changed to Article 45 and amended as: "The funds required for the collection and management of basic medical insurance premiums by medical insurance premium collection agencies and the management of basic medical insurance by medical insurance handling agencies shall be allocated by the finance and shall not be charged from the basic medical insurance fund."

(twenty) by deleting fifty-second and fifty-third.

(21) Article 55 is renumbered as Article 52 and amended as: "If an employer or individual refuses to accept the decisions on basic medical insurance premium, interest, overdue fine, punishment and agreement management made by the medical insurance premium collection agency, medical security administrative department or agency, it may apply for administrative reconsideration or bring an administrative lawsuit according to law. If it fails to apply for administrative reconsideration, bring an administrative lawsuit or perform an administrative decision within the time limit, the medical insurance fee collection agency, the medical security administrative department or the handling agency may apply to the people's court for compulsory execution. "

(twenty-two) the "social insurance registration" in Article 12 is amended as "medical insurance registration"; The "designated medical institutions" in Article 35 is amended as "designated medical institutions or designated retail pharmacies (hereinafter referred to as designated medical institutions)". The "social insurance premium" in Article 47 is amended as "medical insurance premium"; Amend the "designated medical institutions" in Articles 41 and 50 to "designated medical institutions"; The "social insurance administrative department" in this Ordinance shall be uniformly revised as "medical security administrative department", "social insurance agency" as "medical security agency", "social insurance fee collection agency" as "medical insurance fee collection agency" and "hygiene" as "hygiene and health".