It involves the supervision, inspection and management of the medical insurance field to ensure the effective implementation of medical insurance policies and the safe use of medical insurance funds.
1. Supervise the implementation of medical insurance policies. The primary task of the Audit Department of the Medical Insurance Bureau is to supervise the implementation of medical insurance policies.
This includes supervision and inspection of the behavior of medical insurance agencies at all levels, designated medical institutions, insured units and individuals to ensure that medical insurance policies can be effectively implemented and the legitimate rights and interests of insured persons are protected.
2. Check the use of medical insurance funds. Medical insurance funds are an important source of ensuring the medical expenses of insured persons. The Audit Department of the Medical Insurance Bureau needs to strengthen inspections of the use of medical insurance funds.
This includes supervising all aspects of the collection, distribution, and use of medical insurance funds, preventing the abuse and waste of medical insurance funds, and ensuring the safety and effective use of medical insurance funds.
3. Handling medical insurance violations The Audit Division of the Medical Insurance Bureau also needs to deal with violations in the field of medical insurance.
This includes the investigation and handling of various medical insurance fraud, fraudulent insurance and other behaviors, punishing and correcting illegal units and individuals, and maintaining the fairness and justice of the medical insurance system.
4. Strengthen medical insurance publicity and education. In order to improve the awareness and understanding of medical insurance policies among insured persons, the Audit Section of the Medical Insurance Bureau also needs to strengthen medical insurance publicity and education.
Through various forms of publicity and education activities, we will popularize information on medical insurance policies, medical insurance knowledge and medical insurance services to insured persons, and improve the medical insurance awareness and self-protection capabilities of insured persons.
To sum up: the scope of work of the Audit Department of the Medical Insurance Bureau covers many aspects such as supervision of the implementation of medical insurance policies, inspection of the use of medical insurance funds, handling of medical insurance violations, and medical insurance publicity and education.
By strengthening these tasks, the Audit Section of the Medical Insurance Bureau can ensure the effective implementation of medical insurance policies and the safe use of medical insurance funds, safeguard the legitimate rights and interests of insured persons, and promote the healthy development of the medical insurance system.
Legal basis: Article 79 of the "Social Insurance Law of the People's Republic of China" stipulates: The social insurance administrative department shall supervise and inspect the revenue and expenditure, management and investment operation of social insurance funds. If any problems are found, they shall propose rectifications.
Make suggestions and make handling decisions in accordance with the law or make handling suggestions to relevant administrative departments.
The results of social insurance fund inspections should be announced to the public on a regular basis.
Article 80 of the "Social Insurance Law of the People's Republic of China" stipulates: The coordinating regional people's government shall establish a social insurance supervision committee composed of representatives of employers, insured persons, trade union representatives, experts, etc., to control and analyze social insurance
The fund’s revenue and expenditure, management and investment operations, provide consultation opinions and suggestions on social insurance work, and implement social supervision.
Article 5 of the "Regulations on the Supervision and Management of the Use of Medical Security Funds" stipulates: The people's governments at or above the county level shall strengthen the leadership of the supervision and management of the use of medical security funds, establish and improve the supervision and management mechanism of the use of medical security funds, and strengthen the supervision and management of the use of medical security funds.
Capacity building provides guarantee for the supervision and management of the use of medical security funds.
Article 6 of the "Regulations on the Supervision and Administration of the Use of Medical Security Funds" stipulates: The medical security administrative departments, financial departments, and auditing agencies shall supervise and manage the use of medical security funds in accordance with the division of responsibilities, strengthen cooperation and information sharing, and investigate and deal with medical insurance in accordance with the law.
Protection against illegal use of funds.