Brief introduction to the functions of medical insurance bureau in Shehong County;
1. Implement national, provincial, municipal and county laws, regulations, plans, standards and policies on basic medical insurance, maternity insurance and medical assistance, and organize their implementation, supervision and inspection.
2. Implement the supervision and management system of the superior medical security fund. Establish and improve the safety prevention and control mechanism of medical insurance funds, and supervise and strengthen the operation and management of county medical insurance funds.
3 organize the implementation of medical insurance financing and treatment policies, and establish and improve the treatment adjustment mechanism that is compatible with the level of financing. Organize and implement the reform of long-term care insurance system. Organize the implementation of medical assistance.
4. Implement policies such as higher-level drugs, medical consumables prices, medical service items and charges for medical service facilities, put forward suggestions on reasonably determining and dynamically adjusting the price of medical services paid by medical insurance, promote the establishment of a market-led social medical service price formation mechanism, and establish a price information monitoring and information release system.
5. Responsible for the implementation and supervision of the county's drugs and medical consumables bidding procurement.
6. Promote the reform of payment methods of medical insurance funds, formulate agreements and payment management measures for designated medical institutions in this county and organize their implementation, and guide the management of designated medical insurance institutions in this county. Establish and improve the medical security credit evaluation system and information disclosure system, supervise and manage the medical service behavior and medical expenses included in the scope of medical security, and investigate and deal with illegal acts in the field of medical security according to law.
7 responsible for the county medical security management and public service system construction. Responsible for the basic medical insurance, maternity insurance and medical assistance for urban and rural residents and urban workers, and responsible for the transfer and liquidation of medical security relations. Carry out foreign cooperation and exchanges in the field of medical security.
8 responsible for the county-level medical security information construction. Organize the management and application of medical insurance big data.
9. Be responsible for work safety, occupational health, ecological environment protection and convenience examination and approval services within the scope of duties.
10. Complete other tasks assigned by the county party committee and government.
1 1. Function conversion. We will improve the unified basic medical insurance system and serious illness insurance system for urban and rural residents, and constantly improve the level of medical security. Establish and improve a multi-level medical security system covering the whole people and coordinating urban and rural areas, and be responsible for the rational use and safe control of medical security funds.
We will promote the "three-medical linkage" reform of medical care, medical insurance and medicine to better protect the medical needs of the people and reduce the burden of medical expenses.
12. Division of responsibilities.
(1) Division of responsibilities with county health bureau. The two departments should strengthen the convergence of systems and policies in medical care, medical insurance and medicine, establish a communication and consultation mechanism, jointly promote reform, and improve the efficiency of the use of medical resources and the level of medical security.
(2) Division of responsibilities with the county market supervision bureau. The county medical insurance bureau is responsible for the price management of drugs and medical services, and the county market supervision bureau is responsible for the price supervision and inspection of other products.