The medical assistance system in Nijo Castle Township is coordinated by the government and implemented by the civil affairs department. With the cooperation of the health and financial departments, appropriate subsidies will be given to the medical expenses of rural five-guarantee households, rural low-guarantee households and urban low-guarantee households suffering from serious diseases according to certain standards to alleviate poverty caused by illness.
Article 3 The principles of establishing urban and rural medical assistance system: the principle that the level of assistance is compatible with the level of economic and social development and the ability of financial payment; Principle of territorial management; The principles of unified system, standardized management, openness and fairness; Start with a low standard, rescue by classification, and promote as a whole; The principle of saving everything. Article 4 The members of Guzhuang who hold "Five Guarantees", "Rural Minimum Living Security" and "Urban Minimum Living Security" among the permanent residents within the jurisdiction of our district are the targets of medical assistance for serious and serious diseases in urban and rural areas. Medical assistance for serious illness in urban and rural areas, due to serious illness, individuals bear medical expenses of more than 3000 yuan, to give appropriate medical assistance.
Article 5 After the start of the new rural cooperative medical system, rural five-guarantee households and urban and rural subsistence allowances must participate in the rural cooperative medical system before they can enjoy medical assistance for serious diseases in urban and rural areas. After the individual payment policy of rural cooperative medical care is reduced, it is still unable to pay the funds that the individual of rural cooperative medical care should pay, and the District Civil Affairs Bureau will implement all or part of the funding in the medical assistance fund so that they can enjoy the rural cooperative medical care treatment. Due to serious illness, after the cooperative medical subsidy, the individual's annual medical expenses are still more than 3,000 yuan, and then appropriate medical assistance is given.
Article 6 The scope of disease relief provided for in Article 4 of the Measures is limited to the following five categories:
(1) malignant tumor;
(2) leukemia;
(3) uremia;
(4) Severe hepatitis (acute or subacute liver necrosis);
(five) other serious surgical diseases and personal one-time hospitalization expenses reached more than 5000 yuan.
Article 7 Medical assistance for serious illness in urban and rural areas shall be declared, approved and distributed by stages (one-time assistance may be provided when necessary), and the standard of assistance shall be based on the recipient families. If the family's annual accumulated medical expenses are between 3,000 yuan and 5,000 yuan, assistance shall be given according to the standard that the individual bears 20% of the medical expenses; If the family's annual accumulated medical expenses are more than 5,000 yuan, assistance will be provided according to the standard that the individual bears 30% of the medical expenses. The maximum amount of accumulated family assistance for the whole year is 3000 yuan. Article 8 Within 10 days after the treatment of serious illness, the applicant shall submit a written application to the village (neighborhood) committee of the domicile or residence, and truthfully provide the following materials:
(a) when the annual medical diagnosis of major diseases, medical expenses receipts, necessary medical records;
(two) have participated in rural cooperative medical assistance and social mutual assistance;
(three) poor people who have enjoyed other government medical assistance and social assistance;
(4) Household registration book, ID card, copies of five guarantees and minimum living allowances and other supporting materials that should be provided.
Ninth village (neighborhood) committee of the village (neighborhood) people's application, should be accepted in a timely manner, and the applicant to fill out the "medical assistance application form". The village (neighborhood) committee shall, within 5 days, conduct a preliminary examination of the relevant materials provided by the applicant, and submit all the materials to the township office for examination after issuing opinions on the medical assistance application form.
Article 10 Township offices shall examine the medical assistance application forms and related materials submitted by the applicants item by item, and fill in the assistance opinions and amount in the application forms for those who meet the requirements and report them to the District Civil Affairs Bureau for examination and approval; Do not meet the conditions, should explain the reasons, and through the village (neighborhood) committee to inform the applicant in writing. According to the needs, the township office can investigate and verify the applicant's medical expenses and family economic status and other related materials by means of household surveys, neighborhood visits and letters.
Eleventh District Civil Affairs Bureau shall complete the examination and approval of the medical assistance application form and related materials submitted by the township office within 20 working days. To meet the conditions of medical assistance, notify the township office to put forward rescue opinions; Do not meet the conditions of medical assistance, it shall explain the reasons and notify the applicant in writing by the township office. Twelfth the establishment of Wulingyuan District urban and rural serious illness medical assistance fund. The fund is mainly raised through financial allocations at all levels and voluntary donations from the society.
(a) the district finance invested special funds for urban and rural medical assistance according to certain standards, and included them in the fiscal budget at the same level at the beginning of that year.
(two) the higher financial transfer payments into the special funds for urban and rural medical assistance.
(3) Interest income from the medical assistance fund.
(4) Social donations and other funds.
Thirteenth urban and rural medical assistance funds into the financial accounts of social security funds, the implementation of special storage, special account management, earmarking.
Article 14 The District Finance Bureau shall, according to the payment plan and rescue roster submitted by the District Civil Affairs Bureau, implement the capital budget and timely allocate the medical assistance funds to the civil affairs special account.
Fifteenth medical assistance funds by the District Civil Affairs Bureau according to the actual needs, allocated to the township civil affairs office.
Sixteenth medical assistance funds must be closed management, no unit or individual may intercept, occupy or misappropriate, and regularly publish the income and expenditure of medical assistance funds, and accept the supervision of relevant departments and society. Seventeenth people who enjoy medical assistance for serious diseases in urban and rural areas, medical services must be provided by the township hospitals or county hospitals where the household registration is located or where they live. After the implementation of the rural cooperative medical system, medical services are provided by medical service institutions stipulated in the rural cooperative medical system or medical institutions at or above the county level.
Article 18 Medical and health institutions shall, within the prescribed scope, provide medical services for medical assistance objects according to the drug list of new rural cooperative medical care or basic medical insurance, the list of diagnosis and treatment items and the list of medical service facilities. Improve and implement various diagnosis and treatment management systems, ensure service quality and control medical expenses.
Article 19 In case of difficulty or serious illness, the relief object needs to be transferred to a non-designated medical institution, and the transfer formalities shall be handled with reference to the relevant provisions of the rural cooperative medical system or the basic medical insurance institution.
Twentieth medical and health service institutions shall cooperate with the district civil affairs departments to do a good job in the examination and approval of medical assistance benefits, and provide necessary medical records, hospitalization expenses list and other relevant certificates. Article 21 The District People's Government shall set up a leading group for medical assistance for serious illness in urban and rural areas, led by the deputy head in charge and attended by the departments of civil affairs, health, finance, auditing and supervision, and be responsible for the organization, coordination, management and guidance of medical assistance for serious illness in urban and rural areas. Office of leading group for urban and rural medical assistance for serious illness, District Civil Affairs Bureau.
Twenty-second District Civil Affairs Bureau is responsible for the daily management of medical assistance for serious and serious diseases in urban and rural areas in this area. The Township Civil Affairs Office undertakes the daily work such as declaration, examination, verification and reporting of medical assistance for serious illness in urban and rural areas of this unit, and coordinates and handles other matters of medical assistance for serious illness in this area. The village (neighborhood) committee shall set up a review team of 3 to 7 people, and the person in charge shall assist in the daily work of medical assistance for serious illness such as declaration, preliminary examination and reporting.
Twenty-third district finance department shall, jointly with the district civil affairs department, formulate measures for the management of urban and rural serious illness medical assistance funds, timely allocate medical assistance funds in place according to the approved payment plan, and conduct follow-up supervision and inspection.
Twenty-fourth district health departments should strengthen the supervision and management of medical and health institutions providing medical assistance services, and standardize the behavior of medical services; Improve service quality and efficiency, and ensure the implementation of medical assistance policies.
Twenty-fifth district supervision and auditing departments shall track and supervise the management of medical assistance funds and the service quality of medical service institutions, and investigate and deal with violations of discipline and discipline in the management of medical assistance funds and medical services.
Twenty-sixth medical assistance institutions and organizations at all levels in urban and rural areas shall regularly publish medical assistance policies for urban and rural serious diseases, the list of recipients and the amount of assistance, implement a medical assistance publicity system, and accept supervision by the masses.