I. Main functions of Yunyan Medical Insurance Bureau
Yunyan District Medical Security Bureau implements national, provincial and municipal medical security laws and regulations, implements local laws, regulations, policies, plans and standards of provincial and municipal medical insurance, maternity insurance, medical assistance and other medical security systems, formulates departmental management norms and organizes their implementation; Implement the supervision and management measures of provincial and municipal medical insurance funds, the safety prevention and control mechanism of medical insurance funds, and implement the reform of payment methods of medical insurance funds; To undertake the work related to the supervision and management of medical insurance funds; Implement the policy of financing and treatment of medical security, coordinate the treatment of urban and rural medical security, and reform the long-term care insurance system; Do a good job in medical security transactional services; Guide the masses to handle matters related to medical security.
Two. Composition of medical insurance bureau in Yunyan area
Yunyan Medical Insurance Bureau has two internal organs: Office (Fund Supervision Department) and Medicine Management Service Department (Medicine Price Supervision Department). A medical security service center in Yunyan District, a secondary institution.
Three, Yunyan District, medical insurance bureau, the main tasks and policy basis.
1, according to the Notice of the Provincial Finance Bureau of Provincial Medical Insurance on Doing a Good Job in the Collection and Payment of Basic Medical Insurance for Urban and Rural Residents in 2022 (No.202164 of Guizhou Medical Insurance), complete the enrollment tasks assigned by the provincial level and realize the enrollment coverage; Focusing on people's livelihood security, we will vigorously, orderly and effectively strengthen the management of medical insurance.
2. According to the Notice of the Provincial Department of Finance and the Provincial Medical Insurance Bureau on Issuing the Budget of the Central Financial Medical Assistance Subsidy Fund in 2022 in advance (Qian Cai She [202 1] 163), improve the urban and rural medical assistance policy system and fully implement the "three guarantees".
3, according to the "Notice of the Provincial Medical Insurance Bureau on Clear Matters Related to Direct Settlement of Off-site Outpatient Expenses in the Province" document, the implementation of medical insurance benefits, the implementation of off-site medical treatment management and cost settlement policies;
4, in accordance with the requirements of the "Regulations on the Supervision and Administration of the Use of Medical Insurance Funds", comprehensively strengthen the fund safety supervision, and prevent and resolve the fund safety risks;
5. According to the requirements of the Provincial Health and Health Committee of the Provincial Department of Finance and the Provincial Medical Insurance Bureau "Forwarding the Notice of the National Health and Health Committee of the National Medical Insurance Bureau of the Ministry of Finance on Matters Related to the Financial Subsidy of COVID-19 Vaccine and Vaccination Expenses by the Medical Insurance Fund" (Qian Caishe [2021] No.46), we will do our best to prevent and control the epidemic situation;
6. According to the document "Key Points of Deepening the Reform and Optimizing the Business Environment in Guizhou Province in 2020", deepen the "Simplifying Administration and Decentralizing Power, Strengthening Supervision and Improving Service" and pay close attention to the construction of professional ethics;
7, according to the "Fourteenth Five-Year Plan" documents, combined with the work of military and civilian construction, and actively implement the relevant policies to support military medical security.
legal ground
Article 5 The people's governments at or above the county level shall strengthen their leadership over the supervision and management of the use of medical insurance funds, establish and improve the supervision and management mechanism and law enforcement system of the use of medical insurance funds, strengthen the capacity building of the supervision and management of the use of medical insurance funds, and provide guarantee for the supervision and management of the use of medical insurance funds.
"Regulations on the Supervision and Administration of the Use of Medical Insurance Funds" Article 7 The State encourages and supports the news media to carry out public welfare publicity of medical insurance laws, regulations and medical insurance knowledge, and to supervise the use of medical insurance funds by public opinion. Publicity and reports on medical security should be true and fair.
The people's governments at or above the county level and their medical security administrative departments shall solicit opinions in writing, hold symposiums, listen to the opinions of deputies to the National People's Congress, members of the Chinese People's Political Consultative Conference and representatives of insured persons on the use of medical security funds, unblock social supervision channels, and encourage and support all sectors of society to participate in the supervision of the use of medical security funds.
Medical institutions, pharmaceutical business units (hereinafter referred to as pharmaceutical institutions) and other units and medical and health industry associations shall 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.
"Regulations on the Supervision and Administration of the Use of Medical Security Funds" Article 9 The state establishes and improves a unified national medical security handling management system, provides standardized and standardized medical security handling services, and realizes full coverage of provinces, cities, counties, towns (streets) and villages (communities).