Legal analysis: Risk points in medical insurance jobs include unclear understanding of medical insurance policies, insufficient implementation, and lax review.

The business responsibilities of the department are to implement the employee medical insurance benefit policy, formulate an employee medical insurance benefit review system, manually review the outsourced medical expenses of employees, retired and disabled servicemen, and strictly review and review the employee, retired and injured medical insurance expenses settled through the network of designated medical institutions.

Settlement, responsible for the adjustment of employee medical insurance related catalogs, and the daily supervision of each designated medical insurance unit.

The department's business risk management and control measures include regularly focusing on studying the latest medical insurance policies and setting up preliminary and review positions for review.

Legal basis: Article 2 of the "Social Insurance Law of the People's Republic of China" The state establishes basic pension insurance, basic medical insurance, work-related injury insurance, unemployment insurance, maternity insurance and other social insurance systems to protect citizens in the event of old age, illness, work-related injury,

The right to obtain material assistance from the state and society in accordance with the law in cases of unemployment, childbirth, etc.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical insurance and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

Article 28 Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be paid from the basic medical insurance fund in accordance with national regulations.