I. Scope of application of rural cooperative medical care reimbursement:
Farmers participating in the new rural cooperative medical care who are hospitalized due to illnesses are eligible for reimbursement of expenses during hospitalization, including medication fees, bed fees, surgery fees, disposal fees, infusion fees, oxygen fees, routine imaging tests (A-ultrasound, B-ultrasound, electrocardiography, X-rays) as well as routine laboratory tests (blood, urine and fecal matter).
The reimbursement rate:
The hospitalization medical fee reimbursement establishes a starting line and a ceiling line. The standard starting line is 50 yuan for town health centers, 200 yuan for county hospitals within the county, and 500 yuan for hospitals outside the county; the ceiling line is 20,000 yuan, that is, the new rural cooperative medical fund for each person in 1 year the total accumulated hospitalization fees not exceeding 20,000 yuan. Farmers participating in the new rural cooperative medical care are reimbursed for the medical expenses within the scope of reimbursement for each hospitalization, with the portion of the medical expenses below the starting line being borne by the individual, and the portion of the medical expenses exceeding the starting line being reimbursed from the New Rural Cooperative Medical Care Inpatient Medical Fund in segments in accordance with the ratio:
(a) Hospitalization in a town health center and its following designated health care institutions, and reimbursement of hospitalization expenses in the portion of the hospitalization fee of more than 50 yuan in the proportion of 60%.
(2) For hospitalization in county-level designated medical institutions in the county, 40% of the hospitalization fee will be reimbursed for the part of the fee from 201 yuan to 5000 yuan (including 5000 yuan), 50% for the part of the fee from 5001 yuan to 10000 yuan (including 10000 yuan), and 60% for the part of the fee above 10000 yuan.
(3) For hospitalization in designated medical institutions outside the county, the reimbursement rate is 30% for the part of the hospitalization fee from 501 yuan to 5000 yuan (including 5000 yuan); 40% for the part from 5001 yuan to 10000 yuan (including 10000 yuan); and 50% for the part of the hospitalization fee above 10000 yuan.
The part of the hospitalization medical fee that exceeds the compensation cap line will be appropriately subsidized by the county cooperative management office at the end of the year after a unified audit from the cooperative medical care subsidy for major illnesses.
Third, the reimbursement process:
Medical end with medical records, medical bills and "Shayang County New Rural Cooperative Medical Care Certificate", ID card or household registration to the town co-management office or the county medical institutions co-management section to apply for reimbursement, by the town co-management office or the county medical institutions co-management section after reviewing the service medical institutions to be reimbursed instantly.
Four, consulting telephone:
First ask the village committee cadres, township cooperative medical office, the county cooperative management office. Specific business in the township cooperative medical office.
Fifth, the full text reference:
Shayang County, the new rural cooperative medical system implementation measures (for trial implementation)
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Chapter I General Provisions
Article I In order to conscientiously implement the provincial party committee, the provincial government "on the further strengthening of rural health work of the decision" (Efa [2005] No. 5), according to the "Hubei Province, a new type of rural cooperative medical care pilot program" (Egovernment Office [2003] No. 72), combined with the actual situation of the county, to formulate the implementation of these measures.
The second new rural cooperative medical care is organized by the government, guidance, support, individual, collective and government financing, to protect the main disease, farmers voluntarily participate in the medical mutual **** relief system.
Article 3 of the new rural cooperative medical care aims to improve the health of rural residents, to solve the problem of farmers "due to illness, poverty", to achieve the goal of building a moderately prosperous society.
Fourth with the county's permanent agricultural household registration of farmers can participate in the new rural cooperative medical care. Participating farmers must be based on household units, the implementation of a household a certificate system.
Article 5 of the new rural cooperative medical implementation of "county office, county town **** tube" system. County-based management of inpatient medical funds and health examination funds, town-based management of outpatient medical funds.
Chapter II organization
Article VI of the county set up a new rural cooperative medical management committee (referred to as the county cooperative management committee), is responsible for the county's new rural cooperative medical organization, coordination, management and guidance. County Health Bureau for the county's new rural cooperative medical work of the business administration.
Counties and towns set up new rural cooperative medical care management committee office (referred to as the joint management office), for the new rural cooperative medical care agency, responsible for the jurisdiction of the new rural cooperative medical care business management and day-to-day work. The county-level designated medical institutions set up the New Rural Cooperative Medical Care Management Section (referred to as the Harmonization and Management Section), accepting the leadership and management of the county Harmonization and Management Office. Each administrative village set up a new rural cooperative medical care management team.
The town governments and village committees are responsible for assisting in the financing, publicity and organization, and supervision and management of local new rural cooperative medical care.
Article VII of the county co-management office of the universal institutions, the authorized work 5, the office is located in the county health bureau. The town management office for the county management office commissioned by the agency, each town 2 posts, office located in the town health center, the implementation of the separation of management, vertical management. The staff of the county and town co-management offices are recruited openly and on the basis of merit from among the county's financially supported staff and the health system's financially poorly supported staff, and the staff of the town co-management offices are assigned from other places. The staff of county-level medical institutions' co-management sections are appointed on a fixed-term basis. The salaries of the staff of the county co-management office and the full-time staff of the town co-management office and their working expenses shall be unified by the county government and included in the financial budget.
Article VIII of the county, town and village management team of the main responsibilities:
County co-management office of the main responsibilities:
(a) conscientiously implement the relevant policies of the new rural cooperative medical care, is responsible for the county's new rural cooperative medical care organization and coordination work.
(2) to develop relevant supporting management measures.
(3) To assist the relevant departments to raise and manage the new rural cooperative medical fund.
(4) To formulate the annual work program of the new rural cooperative medical care, and the budget and final accounts of the fund.
(5) Supervising the underwriting of medical expenses within the county, and being responsible for the underwriting of medical expenses for hospitalization outside the county in accordance with the regulations.
(6) Producing cards, certificates, forms and registers related to the new rural cooperative medical care.
(7) Providing counseling services to participants of the new rural cooperative medical care.
(viii) It is responsible for training and assessing the management personnel of the town's new rural cooperative medical care, and investigating and punishing violations of the provisions of the new rural cooperative medical care.
(ix) to establish and improve the county's new rural cooperative medical information system, timely collection, collation, analysis, evaluation and reporting of new rural cooperative medical information, new rural cooperative medical paper files management work.
(j) is responsible for the qualification examination and confirmation of the new rural cooperative medical institutions, and the supervision of the quality of services of the designated medical institutions. It examines and approves the relevant outpatient and hospitalization information reported by all designated medical institutions.
(xi) Regularly reporting to the county cooperative management committee, and implementing other tasks assigned by superiors.
The main responsibilities of the town cooperation management office:
(a) Responsible for the organization and coordination of the town's new rural cooperative medical care.
(2) assist the relevant departments to raise and manage the new rural cooperative medical fund.
(3) To establish and improve the new rural cooperative medical care files, fill out, issue and manage the cooperative medical care card.
(4) To be responsible for the examination and reimbursement of outpatient medical expenses, and to conduct the preliminary examination of inpatient medical reimbursement vouchers and write them off in accordance with the regulations.
(5) Signing new rural cooperative medical care agreements with farmers, establishing health records, and providing farmers with new rural cooperative medical care policy consultation services.
(vi) Reporting and publicizing the income and expenditure of the new rural cooperative medical care fund under its jurisdiction.
(vii) To train and assess village-level administrators.
(viii) Implementing other tasks assigned by superiors.
The main duties of the village management team:
(i) Carrying out publicity work and assisting in the collection of the new rural cooperative medical fund.
(2) Supervising the service behavior of village health institutions and the medical behavior of villagers.
(3) To publicize the compensation of local farmers' medical expenses.
(4) Assisting in organizing medical check-ups for farmers and establishing health records.
Article IX county health, finance, audit, supervision, public security, civil affairs, agriculture, development and reform, drug supervision, radio and television, prices, personnel labor and social security, poverty alleviation office, credit unions and other departments in accordance with the relevant provisions of the county, and conscientiously perform their respective duties, and to do a good job of the new rural cooperative medical care.
Article 10 of the county set up a new rural cooperative medical supervision committee, the use and management of the new rural cooperative medical fund, as well as the health services of designated medical institutions for supervision. Supervisory committee by the county people's congress, political consultative conference, discipline inspection, supervision, audit, price and other relevant departments and some deputies to the national people's congress, political consultative conference and participate in the new rural cooperative medical care of the farmers' representatives, of which, the proportion of farmers' representatives not less than 20%.
Chapter III Fund Mobilization
Article 11 of the new rural cooperative medical fund consists mainly of individual farmers to pay voluntary contributions, local financial subsidies, the central government transfer payments in three parts.
(a) Participating in the new rural cooperative medical care farmers pay 15 yuan per person per year.
(2) Local financial subsidies of 15 yuan per person per year according to the number of participants in the new rural cooperative medical care, of which 10 yuan of provincial financial subsidies, county-level financial subsidies of 5 yuan.
(c) the central financial special transfer funds according to the number of participants in the new rural cooperative medical care per person per year subsidies 20 yuan.
Article XII of the rural special hardship card holders of special hardship farmers to participate in the new rural cooperative medical care, the individual part of the payment by the civil affairs department from the relief funds. Rural five-guaranteed households to participate in the new rural cooperative medical care, their individual contributions from the tax reform after the financial transfer of the five-guaranteed households per person per year flat 800 yuan from the funds.
Article XIII of the collective economic organizations, social groups and individuals to support the funding of new rural cooperative medical care by the county co-management office to receive funds.
Article 14 of the new rural cooperative medical fund paid by individual farmers by the town financial office is responsible for the collection, and timely transfer to the new rural cooperative medical fund account.
Article 15 of the end of December each year for the individual to pay the new rural cooperative medical fund deadline, can be paid in advance, but shall not be late to make up for the payment, and shall not be required to return the paid new rural cooperative medical fund. The county co-management office should work with the town co-management office to pay for the new rural cooperative medical fund for the establishment of outpatient family account, fill out the "Shayang County new rural cooperative medical card.
Article 16 farmers to protect against the risk of disease to participate in the new rural cooperative medical care, fulfill the obligation to pay.
Chapter IV Medical Expense Subsidies
Article 17 Farmers participating in the new rural cooperative medical care will be compensated 10 yuan per person per year for outpatient medical expenses, and the compensation will be credited to the outpatient family account.
Article 18: Farmers participating in the New Rural Cooperative Medical Scheme who are hospitalized for treatment of illnesses are entitled to receive compensation for hospitalization expenses, including medication fees, bed fees, surgical fees, disposal fees, infusion fees, oxygen fees, routine imaging tests (A-ultrasound, B-ultrasound, electrocardiogram, X-ray), and routine laboratory tests (blood, urine and fecal matter). A starting line and a ceiling line are set up for the compensation of hospitalization medical fees. The starting line is RMB 50 yuan for town health centers, RMB 200 yuan for county hospitals within the county, and RMB 500 yuan for hospitals outside the county; the ceiling line is RMB 20,000 yuan, i.e., the total amount of hospitalization fees paid by the New Rural Cooperative Medical Fund for each person within one year shall not exceed RMB 20,000 yuan. Farmers participating in the new rural cooperative medical care are reimbursed for the medical expenses within the scope of reimbursement for each hospitalization, with the portion of the medical expenses below the starting line being borne by the individual, and the portion of the medical expenses exceeding the starting line being reimbursed from the New Rural Cooperative Medical Care Inpatient Medical Fund in segments in accordance with the ratio:
(a) Hospitalization in a town health center and its following designated health care institutions, and reimbursement of hospitalization expenses in the portion of the hospitalization fee of more than 50 yuan at a ratio of 60%.
(2) For hospitalization in county-level designated medical institutions in the county, 40% of the hospitalization fee will be reimbursed for the part of the fee from 201 yuan to 5000 yuan (including 5000 yuan), 50% for the part of the fee from 5001 yuan to 10000 yuan (including 10000 yuan), and 60% for the part of the fee above 10000 yuan.
(3) For hospitalization in designated medical institutions outside the county, the reimbursement rate is 30% for the part of the hospitalization fee from 501 yuan to 5000 yuan (including 5000 yuan); 40% for the part from 5001 yuan to 10000 yuan (including 10000 yuan); and 50% for the part of the hospitalization fee above 10000 yuan.
The part of the hospitalization medical fee that exceeds the compensation cap line will be appropriately subsidized by the county cooperative management office at the end of the year after a unified audit from the cooperative medical care subsidy for major illnesses.
The county cooperative management office may make appropriate adjustments to the reimbursement rate according to the actual situation.
Article 19 of the new rural cooperative medical care pregnant women are planned childbirth, hospital delivery costs per person a fixed subsidy of 80 yuan, with obstetric complications included in the scope of hospitalization compensation.
Article 20 of the new rural cooperative medical compensation:
(1) outpatient medical expenses incurred in the designated village health clinic, town health centers, the patient with the "Shayang County New Rural Cooperative Medical Care Card" direct compensation; in the county county designated medical institutions, the patient with the medical cost invoices back to the village health clinic for reimbursement. Each household's annual reimbursement of outpatient medical expenses shall not exceed the balance of the household account, and any balance at the end of the year may be transferred to the following year for further use, but shall not be offset against the portion of the new rural cooperative medical fee payable by the individual in the following year, and shall not be refunded in cash.
(2) Medical expenses incurred in hospitalization in designated medical institutions, according to the method of first payment and then compensation, the medical practitioner shall apply for reimbursement at the end of medical treatment with the documents of medical records, medical expense statement and Shayang County New Rural Cooperative Medical Care Certificate, ID card or household register to the town cooperation management office or the cooperation management section of the county medical institution, and the service medical institution shall be reimbursed instantly after the examination and approval of the cooperation management office of the town cooperation management office or the cooperation management section of the county medical institution. The service medical institution will be reimbursed instantly.
(3) When hospitalization is required due to illness while working, temporarily residing, or visiting relatives outside the county, in principle, the medical expenses incurred for hospitalization in a different place due to a rescue situation shall be reimbursed by the medical practitioner with a diagnostic certificate from the attending medical institution, a copy of the hospitalization record, a duplicate prescription, a list of the medical expenses, and a formal receipt to the county cooperation management office for examination and approval, and the reimbursement rate of each segment shall be adjusted downwards by the county cooperation management office in accordance with the stipulations of the third item of the Article 18 of the present Measures. The reimbursement rate of each paragraph shall be adjusted downward by 10% and then reimbursed.
(4) For medical expenses incurred in hospitalization outside the county approved by the county cooperative management office, the medical expenses incurred in hospitalization outside the county shall be reimbursed directly by the county cooperative management office with reference to the provisions of the third paragraph of Article 18 of the Measures, after the medical expenses incurred in hospitalization outside the county approved by the county cooperative management office shall be reimbursed directly by the county cooperative management office with reference to the provisions of the third paragraph of Article 18 of the Measures, after the medical expenses incurred in hospitalization outside the county approved by the county cooperative management office shall be reimbursed directly by the county cooperative management office with reference to the provisions of the third paragraph of Article 18 of the Measures. Compensation.
(5) During the hospitalization period, in addition to the costs of routine imaging examinations (A-ultrasound, B-ultrasound, electrocardiogram and X-ray) and routine laboratory tests (blood, urine and stool), a reporting and approval system will be implemented when the condition of the patient requires other examinations and tests. Expenses incurred up to and including 200 yuan are reimbursed according to the hospitalization reimbursement ratio; if they exceed 200 yuan, they are included in the hospitalization reimbursement at the rate of 200 yuan.
Article 21 of the new rural cooperative medical care participants of all hospitalization expenses by the receiving medical institution to fill out a list, and by the medical practitioner himself or her family members to sign to confirm. Any medical expenses not signed by the patient or his/her family members shall not be compensated.
Article 22: The following cases are not covered by the new rural cooperative medical care:
(1) Medical expenses incurred in fights, alcoholism, drug abuse, self-inflicted injuries, suicides, and traffic accidents.
(2) identified as medical malpractice or medical malpractice disputes have not yet been identified.
(3) Medical expenses incurred for work-related injuries, employed workers' injuries, occupational diseases, sexually transmitted diseases, family planning and family hospital beds.
(4) Medical expenses incurred without valid referral or transfer procedures or unauthorized visits to non-New Rural Cooperative Medical Care designated medical institutions.
(v) Costs of examinations, treatments and medicines that are not related to the disease and are not in accordance with the prescription (except for exclusionary diagnostic examination costs).
(vi) Medical expenses incurred in irresistible natural disasters, major epidemic epidemics and mass poisoning incidents.
(vii) Expenses incurred for prosthetic eyes, prosthetic limbs, prosthetic teeth, transplanted organs, cosmetic treatment, body beautification, correction of eyesight and tooth rows.
(viii) Medical expenses that do not fall within the scope of "Hubei New Rural Cooperative Medical Care Basic Drug Catalog" and "Diagnostic and Treatment Services Catalog".
(ix) Other non-compensable expenses as stipulated in the Implementing Rules of Shayang County Urban Employees' Basic Medical Insurance System (for Trial Implementation). However, patients suffering from chronic diseases such as advanced cancer, hypertension III, post-stroke, coronary heart disease, severe diabetes mellitus, chronic renal failure, renal transplantation anti-discharge, severe hepatitis, leukemia, etc., their outpatient costs are summarized annually and then subsidized at a flat rate for each type of disease, and the specific standards are formulated separately.
Chapter V Fund Management
Article 23 of the new rural cooperative medical fund to implement the county co-ordination, by the county treasury in the county credit union to set up a new rural cooperative medical fund account, the implementation of the management of the special account storage, earmarked for special purposes, no unit or individual shall not be crowded and misappropriation.
Article 24 of the county co-management office in accordance with the "income and expenditure, balanced income and expenditure, a slight savings, protection of moderate" principle of the preparation of the annual budget of the new rural cooperative medical fund, the end of the year in a timely manner the preparation of the annual accounts, reported to the county co-management committee and the financial sector for approval.
Article 25 of the new rural cooperative medical fund is divided into outpatient medical fund, inpatient medical fund, health checkup fund and risk reserve. The specific standards are as follows:
(1) The outpatient medical fund is 10 yuan per person, and is used to compensate for the outpatient medical expenses of those who participate in the new rural cooperative medical care.
(2) The hospitalization medical fund is 36 yuan per person. Of which: 35 yuan for hospitalization compensation fund, mainly for patients participating in the new rural cooperative medical care within the ceiling line of compensation for hospitalization medical expenses; 1 yuan for the major illnesses subsidy fund, mainly for hospitalization medical cost compensation has exceeded the ceiling line, which may result in "due to illness, poverty, return to poverty due to illness" cases of assistance.
(3) The health checkup fund is 1.5 yuan per person, which is used for an annual health checkup for farmers who have not incurred any medical expenses in the current year.
(d) The risk reserve fund of RMB 2.5 per person per day is used for the financial overdraft of the New Rural Cooperative Medical Care Fund and for emergency treatment of unforeseen circumstances. The size of the risk reserve is maintained at 10% of the total amount of financing for the previous year, and after it is reached, it is no longer withdrawn and the fund is subsumed into the Hospitalization Medical Fund.
Article 26 of the outpatient medical care fund to establish outpatient medical care family accounts on a farm household basis.
Article 27 outpatient medical fees, inpatient medical fees by the county co-management office to the designated medical institutions once a month. Before the 10th day of each month is the settlement time for outpatient medical fees and hospitalization medical fees incurred in the previous month. Health examination fund by the county co-management office at the end of each year to the town of medical examination work assessment and acceptance of the appropriation.
Sixth chapter of the service system
Article 28 of the county joint management committee to participate in the new rural cooperative medical services of the county, town, village three-level medical institutions to implement fixed-point, dynamic management. After the examination and review of qualified, determined as the new rural cooperative medical care designated medical institutions, and announced to the community.
Article 29 to participate in the new rural cooperative medical care of farmers for medical treatment, with my "Shayang County, the new rural cooperative medical card", in the county independently choose the quality, inexpensive, convenient, safe new rural cooperative medical care designated medical institutions.
Article 30 of the new rural cooperative medical care designated medical institutions to participate in the new rural cooperative medical care patients, must be verified, registered, and then disposed of, and in accordance with the "Hubei Province, the new rural cooperative medical care service norms" requirements, to provide good medical care for the patients. Medical personnel shall adhere to the principle of "treating the patient according to his illness, rationally administering medication, and reasonably conducting examinations", and correctly guide farmers to reasonably seek medical treatment. Medical institutions should strictly implement the "Hubei Provincial New Rural Cooperative Medical Care Basic Medication Catalog", and the use of non-cooperative medicine must be signed by the patient or his/her family members. The cost of non-cooperative medicine shall not exceed 5% of the total cost of medicines in township-level designated medical institutions; and shall not exceed 15% of the total cost of medicines in county-level designated medical institutions.
Article 31 strengthens the construction and management of village-level health organizations, and actively promotes the integration of the management of town and village health organizations, and improves the new rural cooperative medical service network.
Article 32 of the new rural cooperative medical care patients in hospitalization and treatment need to be referred to treatment, the county by the referral medical institutions to issue referral certificates, and timely report to the Office of the county co-management. Because of the condition needs to go outside the county clinic, must go to the county cooperative management office for approval procedures. Critically ill patients can be admitted to the hospital first, but the referral approval procedures must be completed within three days. For patients who need to be referred to a higher level of medical institutions for treatment, the lower level of medical institutions should be referred in a timely manner, and should not be intercepted; for those whose condition is stable and need rehabilitation treatment, the higher level of medical institutions should be referred to the lower level of medical institutions to continue the treatment.
Article 33 of the establishment of farmers' health records, each year by the town health center organization of the year did not incur medical expenses to participate in the new rural cooperative medical care for farmers to carry out a health check-up, medical examination project by the county co-management office to determine.
Article 34 of the farmers participating in the new rural cooperative medical care due to hukou migration out of the county or death, the villagers' committee should be reported within 30 days of the township co-management office, the township co-management office from the date of receipt of the report to the county co-management office for cancellation and other formalities within 7 days.
Chapter VII Supervision and Management
Article 35 of the new rural cooperative medical institutions to strengthen financial management, and accept the supervision and management of the health administrative departments and financial departments. Audit department to audit its income and expenditure every year, and report to the county government, the county cooperative management committee audit, and publicize the results of the audit to the community.
Article 36 of the new rural cooperative medical care designated medical institutions shall publicize the "Hubei Province, the new rural cooperative medical care basic medication directory", "basic medical services settlement standards, surgical project settlement standards", "the new rural cooperative medical care cost compensation process", "participate in the cooperative medical care of the rights and obligations of farmers", and monthly publicity on the compensation of the new rural cooperative medical care fund.
Article 37 of the county and township co-management office to the community to publish the new rural cooperative medical complaints telephone, and from the date of receipt of the complaint within five days of the complaint matters to give a reply.
Chapter VIII assessment and rewards and punishments
Article 38 of the county co-management office is responsible for the county's new rural cooperative medical work assessment of the new rural cooperative medical work has made outstanding contributions to the units and individuals by the county government to be commended.
Article 39 of the new rural cooperative medical institutions have one of the following behaviors, the health administrative department shall order correction, the person in charge and directly responsible for administrative sanctions. If it constitutes a crime, it shall be transferred to the judicial organs for handling according to law:
(1) Unauthorized changes in the scope of reimbursement and reimbursement standards.
(ii) misappropriation, misappropriation, embezzlement of the new rural cooperative medical fund.
(3) Mismanagement resulting in a serious deficit of the new rural cooperative medical fund.
(4) Other violations of the new rural cooperative medical care management regulations.
Article 40 of the new rural cooperative medical institutions and their staff have one of the following behaviors, depending on the severity of the case, it will be notified and criticized, and ordered to rectify the situation within a certain period of time, refused to rectify or rectify the ineffective, the cancellation of its qualification for the fixed, and the relevant responsible person shall be given administrative sanctions. Is a medical personnel personal behavior, cancel its new rural cooperative medical prescription right, by the county health administrative department in accordance with the relevant provisions of the "Practicing Physicians Law" to investigate and deal with:
(a) of the new rural cooperative medical work leadership, cooperation, management measures are not in place, affecting the normal work of the new rural cooperative medical work.
(2) does not strictly implement the new rural cooperative medical care basic diagnosis and treatment catalog, drug catalog, service facility standards and national pricing policy, decomposition of charges, indiscriminate charging.
(3) does not strictly implement the diagnosis and treatment standards, does not adhere to the first hospital, the first section, the first diagnosis of the system of responsibility, shirking patients, arbitrary referrals, arbitrarily relaxing the admission criteria, intentionally prolonging the patient's hospitalization time, the misuse of large-scale inspection equipment, repeat examinations.
(d) medical personnel do not verify, registration and treatment, or to facilitate the impersonation of medical practitioners.
(E) violation of the provisions of the new rural cooperative medical care medication, prescribing favors, large prescriptions, not in accordance with the provisions of the limited number of medication, prescribing outdated or overdated prescriptions.
(F) taking advantage of the work, ride-along prescribing, or joining hands with the people who seek medical treatment to falsify, the basic medicines will be strung together and exchanged for out-of-pocket medicines, health care products, and daily necessities.
(vii) incurring medical expenses for self-paid medicines, special examinations and treatments, and diagnostic and therapeutic services beyond the basic scope without obtaining the consent and signature of the person seeking medical treatment or his/her family members.
(viii) Other violations of the new rural cooperative medical management regulations.
Article 41 of the new rural cooperative medical care participants who have one of the following acts, in addition to recovering from them the reimbursed medical expenses, depending on the severity of the case, to give criticism, suspension of the new rural cooperative medical care treatment and other sanctions, constitutes a crime, according to the law, transferred to the judicial organs to deal with:
(a) the cooperative medical care card will be lent to other people to seek medical treatment.
(2) Issuing false medical receipts and prescriptions and fraudulently claiming compensation funds for the new rural cooperative medical care.
(3) Failure to comply with the procedures of the new rural cooperative medical care for their own reasons, resulting in medical expenses not being compensated for and unreasonable.
(D) privately altering medical receipts, medical records, prescriptions, inspection reports, or prescribing their own medicines, conducting inspections in violation of the law, or authorizing medical and nursing staff to make false statements.
(E) using the new rural cooperative medical care in the designated medical institutions to prescribe drugs for illegal resale.
(F) other violations of the new rural cooperative medical care management.
Chapter IX Supplementary Provisions
Article 42 of the county co-management office in accordance with the implementation of the measures to develop relevant supporting management measures. These measures shall be interpreted by the county cooperative management office.
Article 43 of the Measures shall come into force from January 1, 2006 onwards.
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