Legal analysis:
1. Responsible for the organization and implementation of urban resident registration and insurance in the district and county; responsible for the publicity, training and expansion of insurance coverage for urban employee medical care and urban resident medical insurance in the district and county. 2. Supervise and inspect the participation and payment of urban employee medical insurance, urban resident medical insurance and maternity insurance by employers in the district and county to ensure the insurance participation rate and collection rate. 3. Responsible for the supervision and inspection of the implementation of the basic medical insurance system in designated medical institutions and retail pharmacies in the district and county. 4. Supervise and inspect the collection and payment of premiums for urban employee medical insurance, urban resident medical insurance and maternity insurance by the medical insurance agencies in this district and county. 5. Organize and promote medical subsidies for civil servants in the district and county. 6. Responsible for the review of medical insurance certificates and payment period of insured persons.
Legal basis:
"Opinions of the General Office of the State Council on Comprehensively Promoting the Integrated Implementation of Maternity Insurance and Employee Basic Medical Insurance"
(1) Unified insurance registration . Employees who participate in the basic medical insurance for employees also participate in maternity insurance. During the implementation process, it is necessary to improve the scope of insurance, find out the bottom line based on the universal insurance registration plan, and promote the realization of all the insurance that should be covered.
(2) Unify fund collection and management. The maternity insurance fund is integrated into the employee basic medical insurance fund, collected and paid uniformly, and the overall planning level is consistent. The new employee basic medical insurance rate of the employer shall be determined based on the sum of the employer’s contribution ratio for maternity insurance and employee basic medical insurance. Individuals shall not pay maternity insurance premiums. At the same time, based on the expenditure of employees' basic medical insurance funds and the needs for maternity benefits, and in accordance with the principle of balancing revenue and expenditure, a rate determination and adjustment mechanism is established. The basic medical insurance fund for employees strictly implements the financial system of social insurance funds. It no longer lists maternity insurance fund income separately, but sets up maternity benefit expenditure items in the basic medical insurance overall fund benefit expenditure for employees. Explore and establish a sound fund risk early warning mechanism, adhere to the disclosure of fund operations, strengthen internal control, strengthen fund administrative supervision and social supervision, and ensure the safe operation of funds.
(3) Unified medical service management. After the merger of the two insurances, unified designated medical service management will be implemented. When medical insurance agencies sign relevant medical service agreements with designated medical institutions, they must add relevant requirements and indicators for reproductive medical services to the content of the agreement, make full use of agreement management, and strengthen the monitoring of reproductive medical services. Implement basic medical insurance, work-related injury insurance, and maternity insurance drug catalogs as well as basic medical insurance diagnosis and treatment items and medical service facility scope. Promote behavioral norms for reproductive medical services. Incorporate maternity medical expenses into the scope of the reform of medical insurance payment methods, and promote the payment of medical expenses such as hospitalization and childbirth based on disease types and prenatal examinations on a per-capita basis. In principle, maternity medical expenses are settled directly between medical insurance agencies and designated medical institutions. Make full use of the medical insurance intelligent monitoring system, strengthen monitoring and auditing, and control the unreasonable increase in fertility medical expenses.