Medical institutions and retail pharmacies applying for inclusion in the medical insurance designated medical institutions and retail pharmacies need to meet the following conditions: medical institutions and retail pharmacies need to meet the operating time of not less than 3 months, and have certain operating licenses qualifications, the provision of services to the staff and other basic conditions. There is at least one physician who has obtained a medical practitioner's license, a rural doctor's license or a Chinese medicine (specialty) physician's qualification certificate and whose first place of registration is in the medical institution.
The "two measures" also detailed the rights, obligations and responsibilities of the subject of the agreement. Clearly designated medical institutions, designated retail pharmacies in accordance with the agreement to provide services, the implementation of the relevant policies and regulations of the health insurance, as required to report information to the health insurance agency, for the insured service, and should cooperate with the health insurance agency to carry out the health insurance cost audit, performance assessment. The medical insurance agency provides services in accordance with the agreement, and carries out fee audits and performance appraisals.
In summary, the above, a clear agreement on the subject of the responsibility of the breach of contract, put forward the agreement to suspend and terminate the specific circumstances, equivalent to a "negative list", is conducive to promoting the standardization of medical services, to ensure the safety of health insurance funds, but also conducive to promoting the standardization of the management of health care institutions and retail pharmacies designated, the rule of law.
Legal
Legal basis:
Interim Measures for the Management of Medical Insurance Designation of Medical Institutions
Article 5
Designated medical institutions shall have the following conditions:
1. Comply with the planning of the setting up of medical institutions in a regional area;
2. Comply with the standards for the accreditation of medical institutions;
3. Comply with the national laws, regulations and standards concerning the medical service management laws, regulations and standards, and has a sound and perfect medical service management system;
4. Strictly implements the price policy of medical services and medicines stipulated by the price departments of the state, provinces (autonomous regions and municipalities directly under the central government), and is qualified by the price department's supervision and inspection;
5. Strictly implements the relevant policies and regulations of the basic medical insurance system for urban workers and establishes internal management systems that are in line with the management of the basic medical insurance. Management of the internal management system compatible with the management, equipped with the necessary management personnel and equipment.