What is the management method of health insurance?

The Measures for the Administration of Health Insurance highlights the nature of health insurance protection, adapts to the new situation and new requirements of health insurance management and supervision, and strives to meet the growing health protection needs of the people. The definition and classification of health insurance, product supervision and sales operation have been comprehensively revised. , standardize the design, sales operation and claims settlement of health insurance products, and encourage health insurance to fully assume social responsibilities.

1. Conceptual positioning: positioning health insurance as an important part of the national multi-level medical security system, improving the definition and business classification of health insurance, and incorporating medical accident insurance into health insurance. In terms of product specifications and business sales, it is necessary to clarify the conditions for operating health insurance and improve the professional management level; Adhere to the nature of health insurance protection, and clarify the product characteristics and requirements of various health insurance products; Encourage insurance companies to apply information technology and big data to health insurance product development, risk management, claims and other links to improve management level.

2. In the protection of consumers' rights and interests, it is forbidden for insurance companies to sell health insurance products with other products, and it is not allowed to induce repeated purchases of cost-compensated medical insurance products with the same or similar protection functions; It is clear that an insurance company may not require the insured to provide or illegally collect or obtain genetic information or genetic testing data of the insured except family history; Absorb and adopt relevant medical reform policies in recent years, such as giving preferential support to the poor.

For the first time, Health Management was written into a special chapter in the Measures for the Administration of Health Insurance, which defined the main contents of health management, the relationship between health management and health insurance, and the cost.

3. In the next step, the CBRC will continue to implement the requirements of the CPC Central Committee and the State Council on the development of health insurance, publicize and implement the Measures for the Administration of Health Insurance, improve relevant supporting rules, and guide the insurance industry to better serve the reform of the national medical and health system and the implementation of the healthy China strategy.