1, clinical diagnosis and treatment necessary, safe and effective, the cost of appropriate diagnosis and treatment projects;
2, by the price department has set the standard of charges for the diagnosis and treatment projects;
3, by the designated simple trillion Medical institutions for the insured to provide medical services within the scope of the diagnosis and treatment items.
I. Content of basic medical services
This definition includes the following connotations:
1. Clearly define the scope of diagnostic and treatment programs. In clinical medical services, diagnosis and treatment-related services are very many, but not all medical services are diagnosis and treatment programs. According to this definition, the diagnosis and treatment project refers to the medical technology labor project, such as the embodiment of medical labor diagnosis and treatment fee, surgical fee, anesthesia fee, laboratory fee, etc., the embodiment of nursing labor nursing fee, injection fee, etc., but does not include some non-medical labor, such as nursing, food and beverage and other living services. The second refers to the use of medical instruments, equipment and medical materials for diagnostic and therapeutic projects, such as laboratory instruments related to testing, B ultrasound, CT and other diagnostic equipment, a variety of infusion, catheters, artificial organs and other medical materials, excluding some non-diagnostic, therapeutic use of instruments, equipment and materials do not fall within the scope of diagnostic and therapeutic projects, such as instruments and equipment used for hospital management, improve the living environment of the service facilities, etc..
2, to determine the basic medical insurance treatment program should have three conditions: First, clinically necessary, safe and effective, appropriate cost of treatment program. Clinically necessary, is necessary for clinical treatment of disease, is relative to non-disease treatment of diagnostic and therapeutic items such as cosmetic surgery, as well as the main diagnostic and therapeutic means of disease treatment relative to auxiliary diagnostic and therapeutic means such as music therapy. Safe and effective refers to mature items that have been widely recognized through long-term clinical use, as opposed to some diagnostic and therapeutic measures that are still in the research stage and whose efficacy is not certain, such as heart, lung and brain transplants. The cost is appropriate, that is, it should be compatible with the ability to pay of the basic medical insurance fund.
Legal basis:
The Chinese People's **** and the State Social Insurance Law
Article 2 of the State to establish a basic old-age insurance, celery refers to the basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, and other social insurance system, to ensure that the citizens in the case of old age, stop the first tenant disease, industrial injury, unemployment, childbirth, etc. The right to receive material assistance from the State and society in accordance with the law.
Article 3 of the social insurance system adheres to the broad coverage, basic, multi-level, sustainable approach, the level of social insurance should be commensurate with the level of economic and social development.