what are the obligations of designated medical institutions?

(I) Obligation to standardize medical service behavior

Article 7 stipulates that medical institutions, pharmaceutical business units (hereinafter referred to as medical institutions) and medical and health industry associations should strengthen industry self-discipline, standardize medical service behavior, promote industry norms and self-discipline, and guide the rational use of medical security funds according to law.

(II) Obligation to provide medical services and improve service quality

Article 12 stipulates that designated medical institutions shall provide medical services in accordance with regulations, improve service quality, rationally use medical security funds and safeguard citizens' health rights and interests.

(III) Obligation to Establish Relevant System of Medical Insurance Fund

Article 14 stipulates that designated medical institutions shall establish an internal management system for the use of medical insurance funds, and specialized agencies or personnel shall be responsible for the management of the use of medical insurance funds, and establish and improve the evaluation system.

(4) Obligation to carry out training on relevant systems and policies of medical insurance funds

Article 14 stipulates that designated medical institutions shall organize training on relevant systems and policies of medical insurance funds, regularly check the use of medical insurance funds in their own units, and promptly correct the irregular use of medical insurance funds.

(V) Obligation to verify the medical insurance vouchers of the insured

Article 15 stipulates that designated medical institutions and their staff should implement the management regulations on real-name medical treatment and drug purchase, verify the medical insurance vouchers of the insured, provide reasonable and necessary medical services according to the diagnosis and treatment norms, and truthfully issue expense documents and relevant materials to the insured, and must not break down hospitalization and hanging bed hospitalization. Do not violate the norms of diagnosis and treatment by over-diagnosis, over-examination, decomposition of prescriptions, over-prescribing and repeated prescribing, repeated charging, over-standard charging, decomposition of project charges, swapping drugs, medical consumables, diagnosis and treatment items and service facilities, or inducing or assisting others to impersonate or falsely seek medical treatment or purchase drugs.

(VI) Obligation to provide informed consent for the insured

Article 15 stipulates that designated medical institutions shall ensure that the expenses paid by the medical security fund meet the prescribed payment scope; Except in special circumstances such as emergency and rescue, providing medical services beyond the scope of medical security fund payment shall be subject to the consent of the insured or their close relatives and guardians.

(VII) Make medical insurance fund information public and accept social supervision

Article 16 stipulates that designated medical institutions shall keep financial accounts, accounting vouchers, prescriptions, medical records, treatment and inspection records, expense details, and records of drugs and medical consumables in and out of the warehouse in accordance with regulations, timely and comprehensively and accurately transmit relevant data on the use of medical insurance funds through the medical insurance information system, report the information needed for the supervision and management of the use of medical insurance funds to the administrative department of medical insurance, and disclose medical expenses and medical consumables to the public.

(VIII) Other related obligations

Article 18 stipulates that in the process of using the medical security fund, designated medical institutions and their staff shall not accept bribes or obtain other illegal income.

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Article 19 stipulates that designated medical institutions shall not provide convenience for insured persons to resell drugs, accept the return of cash or kind or obtain other illegal benefits by taking advantage of their medical security benefits.

Article 2 Designated medical institutions and their staff shall not defraud the medical security fund by forging, altering, concealing, altering, destroying medical documents, medical certificates, accounting vouchers, electronic information and other relevant materials, or fabricating medical service items.

Article 21 stipulates that the medical security fund shall be used exclusively, and no organization or individual may occupy or misappropriate it.

Article 3 If a designated medical institution is suspected of defrauding the medical security fund, the designated medical institution shall cooperate with the administrative department of medical security during the investigation.