Article 1 These Measures are formulated in accordance with the relevant provisions of the state and the province and in combination with the actual situation of this Municipality in order to ensure the normal medical treatment of Class I and II health care objects. Article 2 These Measures shall apply to Class I and Class II medical insurance objects (except retirees, the same below) in all units participating in the basic medical insurance for urban workers in Shinan District, Shibei District, sifang district District and Licang District of this Municipality. Third medical insurance objects enjoy Medicaid on the basis of participating in the basic medical insurance for urban workers. Article 4 The medical subsidy standard for health care objects shall be determined comprehensively after deducting the expenses raised by basic medical insurance at 8% of the total wages according to the public medical service standard in 2000, and adjusted according to a certain proportion every year. Article 5 Raising of Medicaid expenses: The unit where the Medicaid recipients work shall pay to the medical insurance agency on a quarterly basis, which shall be included in the social security fee. The Medicaid funds of organs and financial institutions shall be arranged by the separate budget of the finance at the same level. Non-financial institutions and enterprises shall be borne by the unit. Article 6. 50% of Medicaid expenses for health care objects are included in individual medical accounts and used according to the relevant provisions of basic medical insurance. The rest of the expenses as transfers by the municipal social medical insurance agencies to implement financial account management, mainly for subsidies to solve the special medical expenses outside the scope of basic medical payment of medical insurance objects and the self-paid part of the expenses above the maximum payment limit of social pooling funds. Seventh one or two kinds of health care objects for medical treatment, the following expenses by the receiving hospital after the municipal social medical insurance agency audit separate bookkeeping, at the end of each quarter to the municipal social medical insurance agency verification:
(a) the health care object is hospitalized in the prescribed cadre health ward, which exceeds the bed standard stipulated by the basic medical treatment;
(two) the self-paid part of the hospitalization medical expenses above the maximum payment limit of the basic medical social pooling fund. When the funds in the personal account are insufficient, the first-level health care object will be fully reimbursed, and the second-level health care object will be reimbursed 80%;
(three) for a class of health care objects, according to the needs of the disease, it is really necessary to pay other medical expenses. Article 8 The medical security objects included in the payment scope of basic medical insurance shall be implemented in accordance with the relevant provisions of basic medical insurance. Medical and health care services are implemented according to the standards formulated by the Municipal Health and Health Commission, and the health examination fees are still charged according to the original channels. Article 9 Personal medical account cards of medical care objects shall not be lent to relatives and others for use. In violation of the provisions, cancel its medical subsidies. Tenth problems in the specific implementation of these measures, the municipal labor and social security administrative department is responsible for the interpretation of. Article 11 These Measures shall come into force as of July 1 day, 2000.