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1. Include more outpatient expenses in medical insurance reimbursement.
The meeting pointed out that China's new round of medical reform has established the largest basic medical insurance network in the world, benefiting more than one billion people and playing an important role in reducing the medical burden and expenses of the people. In recent years, chronic diseases such as hypertension and diabetes involving many patients have been included in the scope of medical insurance reimbursement. The next step is to deepen medical reform, enhance the mutual aid function of employees' basic medical insurance, and include more outpatient expenses in medical insurance reimbursement to further reduce the burden on patients.
2. The unit payment is no longer included in the personal account.
The meeting decided to improve the personal account calculation method. Individual contributions of on-the-job employees are still included in my personal account, and all unit contributions are included in the overall fund; Retirees' personal accounts are allocated by the overall fund according to the quota, and the allocated amount is gradually adjusted to about 2% of the average basic pension level in the year when the reform was implemented in the overall planning area.
3. Family members can use personal accounts
The meeting decided to expand the scope of personal accounts, allow family members to help each other pay for medical treatment in designated medical institutions and purchase medicines, medical devices and medical consumables in designated retail pharmacies, and explore individual contributions from family members to participate in basic medical insurance for urban and rural residents. This means that the funds entering the personal account have decreased, but the use of the personal account has expanded.
4. Strengthen the supervision and management of medical insurance funds.
The meeting decided to strengthen the supervision and management of medical insurance funds, improve the audit and internal control system, severely investigate and deal with illegal acts such as false hospitalization and fraudulent insurance, and improve the payment mechanism suitable for outpatient mutual assistance.
Medical insurance fund is the money people use to save lives, but some people regard it as? Tangseng meat? Do everything possible to learn from it? Leak it? , defrauding the medical insurance fund.
The data shows that in 2020, more than 600,000 designated medical institutions will be inspected, more than 400,000 illegal designated medical institutions will be investigated, and the medical insurance fund will be recovered by 22.3438 billion yuan. More than half of the designated medical institutions have problems in the use of funds to varying degrees.
With the strengthening of the supervision and management of medical insurance funds, insurance fraud and other illegal acts will become more serious? Strong supervision?
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