What is the medical insurance bureau?
The unit nature of the medical insurance bureau is the state administrative organ, which is subordinate to the local human resources and social security bureau.
Responsible for accepting the approval, payment and management of basic medical insurance, work-related injury insurance, maternity insurance and medical expenses pooling fund for retired cadres, and providing corresponding management services for employers, employees and retired cadres who participate in basic medical insurance, work-related injury insurance and maternity insurance.
In order to improve the unified basic medical insurance system and serious illness insurance system for urban and rural residents, continuously improve the level of medical security, ensure the rational use, safety and controllability of medical insurance funds, and promote the reform of "three medical linkages" of medical care, medical insurance and medicine as a whole.
In order to better ensure medical care for the sick, the State Council's institutional reform plan proposes to integrate the responsibilities of basic medical insurance and maternity insurance for urban workers and urban residents in Ministry of Human Resources and Social Security and the new rural cooperative medical care of the National Health and Family Planning Commission.
The National Development and Reform Commission's responsibility for the price management of drugs and medical services and the Ministry of Civil Affairs' responsibility for medical assistance will be integrated, and the National Medical Insurance Bureau will be established as a directly affiliated institution of the State Council.
2065438+In March, 2008, the first meeting of the 13th National People's Congress passed the Decision on the Institutional Reform Plan of the State Council, and established the National Health Insurance Bureau of People's Republic of China (PRC).
What is the nature of the medical insurance bureau?
Belonging to public institutions, its main responsibilities are as follows:
(a) responsible for the preparation, management, payment and audit of the medical insurance fund in this Municipality.
(two) responsible for the personal account management and fund settlement and payment of medical insurance in this Municipality.
(three) responsible for the audit, settlement and medical management of social insurance medical expenses in the overall planning area.
(four) responsible for the management of public medical care in this Municipality and the audit, settlement and management of basic (subsidized) medical expenses for civil servants.
(five) responsible for the organization and implementation of the new medical reform plan, as well as the settlement of medical expenses and medical management services for the insured persons in the non-integrated areas of this Municipality.
(six) responsible for signing medical service agreements with social insurance designated medical and pharmaceutical institutions, and conducting relevant policy propaganda and business training; Assist the administrative department of labor and social security to guide, supervise, inspect, regularly evaluate and assess the implementation of policies and regulations and medical service agreements of designated medical and drug institutions, and implement resident supervision and management of designated medical institutions; Responsible for the audit of medical expenses of designated medical and pharmaceutical institutions.
(seven) responsible for the supervision and inspection of the specific outpatient items handled by the secondary agencies, as well as the second follow-up, referral, medical treatment in different places and other business matters.
(eight) responsible for the preparation of standards, procedures and publicity materials for the management of social insurance medical services, providing inquiry and consulting services for related businesses and accepting related complaints.
(nine) to be responsible for the requirements and testing of social insurance medical business information system, and to be responsible for the construction of standard library and data management and maintenance.
(ten) to organize and participate in the investigation and statistical analysis of social insurance medical services and related policies.
(eleven) responsible for the overall planning, command and management of secondary medical insurance agencies.