The people's governments above the flag county level health, market supervision and management, finance, audit, public security and other departments should be in accordance with their respective responsibilities to do a good job of supervision and management of the use of medical insurance fund related work. Article 6 encourages and supports the news media to carry out public welfare propaganda of medical insurance laws, regulations and knowledge of medical insurance. Propaganda reports on medical insurance shall be true and fair.
Encourage and support all aspects of society to participate in the supervision of the use of medical insurance fund. Article 7 The use of medical insurance fund shall be consistent with the scope of payment of state regulations.
The people's governments of autonomous regions in accordance with the authority and procedures prescribed by the state, supplemented by the development of the administrative region of the medical insurance fund to pay for specific items and standards, and reported to the state council administrative department of medical insurance for the record. Article VIII of the people's governments at or above the flag county level, the administrative department of medical insurance to perform the following supervisory and management duties:
(1) establish and improve the supervision and management system of the use of the medical insurance fund;
(2) standardize the medical insurance business;
(3) supervise the conclusion of the service agreement, the implementation of the situation;
(4) supervise the inclusion of the scope of the payment of the medical insurance fund The medical service behavior and medical costs;
(E) investigate and deal with illegal use of medical insurance fund;
(F) laws and regulations provide for other supervisory duties. Article 9 The medical insurance administrative department of the people's government at or above the flag county level shall supervise the performance of the following duties by the medical insurance agencies:
(1) establishing and improving operational, financial, safety and risk management systems;
(2) signing and fulfilling service agreements with designated medical institutions and designated retail pharmacies;
(3) fund disbursement, examination and payment of treatment
(4) to the public medical insurance fund income, expenditure, balance, etc.
(5) to the community to publish a list of designated medical institutions and designated retail pharmacies;
(6) to provide medical insurance information query service;
(7) other duties prescribed by laws and regulations. Article 10 The medical insurance administrative department of the people's government at or above the flag county level shall supervise the performance of the following duties by the designated medical institutions:
(1) fulfillment of the service agreement;
(2) implementation of the national and autonomous regional prices of medical services and centralized purchasing system for medicines and medical consumables;
(3) transmitting to the medical insurance information system the use of the medical insurance fund Relevant data;
(4) to the public medical expenses, cost structure information;
(5) other duties prescribed by laws and regulations. Article 11 The medical insurance administrative department of the people's government at or above the flag county level shall supervise the fulfillment of the following duties by the designated retail pharmacies:
(1) fulfillment of the service agreement;
(2) transmitting to the medical insurance information system the data relating to the use of the medical insurance fund;
(3) disclosure of information about the cost of medicines to the society;
(4) other duties prescribed by laws and regulations, (d) Other duties prescribed by laws and regulations. Article XII of the fixed-point medical institutions, fixed-point retail pharmacies and their staff shall implement the real-name medical and pharmaceutical management regulations, verify the medical insurance vouchers of participants, in accordance with the diagnostic and treatment specifications to provide reasonable and necessary pharmaceutical services, to the insured person truthfully issued bills and related information, shall not be disaggregated inpatient hospitalization, hospitalized in the hospital, shall not be in violation of the norms of overdiagnosis and treatment, excessive examination, disaggregation of the prescriptions, overprescribing medicines, Repeated prescribing of medicines, repeated charging, over-standard charging, itemized charging, collusion of medicines, medical consumables, diagnostic and therapeutic items and service facilities, and inducing or assisting other people to seek medical treatment and purchase medicines under false names or in a false manner.
In addition to emergency, rescue and other special circumstances, the designated medical institutions to provide medical services outside the scope of payment of medical insurance fund, shall be agreed by the insured person or his close relatives, guardians. Article 13 The insured person shall hold his/her own medical insurance voucher for medical treatment and purchase of medicines, and take the initiative to present it for inspection. Participants have the right to request the designated medical institutions, designated retail pharmacies to truthfully issue bills and related information.
Participants shall enjoy medical insurance benefits in accordance with the regulations and shall not be entitled to duplicate benefits.
Participants shall have the right to request the medical insurance organization to provide medical insurance consulting services and make suggestions for improvement in the use of the medical insurance fund.