Main responsibilities
(a) Implementation of national, provincial and municipal medical insurance, maternity insurance, medical assistance and other medical insurance laws and regulations and policies and planning standards, and formulate the county's relevant policies, planning and standards and organize the implementation.
(2) implement the supervision and management of medical insurance fund, establish and improve the fund safety prevention and control mechanism, and promote the reform of medical insurance fund payment method.
(3) the implementation of provincial and municipal medical insurance financing and treatment policies, improve the dynamic adjustment and transfer and balance mechanism, urban and rural medical insurance treatment standards, establish and improve the treatment adjustment mechanism in line with the level of financing. Implement the provincial and municipal long-term care insurance system reform program and organize the implementation.
(d) Implementing the unified provincial and municipal urban and rural medical insurance catalogs and payment standards for medicines, medical consumables, medical service items and medical service facilities, and implementing the dynamic adjustment mechanism.
(5) implementation of provincial and municipal drugs, medical consumables prices and medical services, medical service projects, medical services and facilities charges and other policies, the establishment of medical insurance to pay for medical services prices reasonably determined and the dynamic adjustment mechanism, and promote the establishment of a market-led price formation mechanism for social medical services, the establishment of price information monitoring and information dissemination system.
(F) the implementation of provincial and municipal drugs, medical supplies bidding and procurement, distribution and settlement management policies, guidance and promote the county's health care institutions drugs, medical equipment, medical supplies centralized purchasing supervision and management work, play the role of bidding and procurement of drugs, medical supplies platform supervision.
(VII) to develop the county fixed-point medical institutions agreement and payment management and organization and implementation, establish and improve the medical insurance credit evaluation system and information disclosure system, supervision and management of medical services included in the scope of medical insurance and medical costs, according to the law to investigate and deal with violations of law and regulations in the field of medical insurance.
(viii) is responsible for medical insurance management, public ****service system and information construction, organizing and implementing the management of medical treatment in other places, cost settlement policy and medical insurance relationship transfer and succession system, and carrying out foreign cooperation and exchanges in the field of medical insurance.
(ix) Completing other tasks assigned by the county party committee, the county government and higher-level business departments.
(j) Functional transformation. County Medical Security Bureau should continue to improve the county's unified basic medical insurance system for urban and rural residents and the major disease insurance system, to establish and improve the coverage of the entire population, urban and rural integration of multi-level medical security system, and constantly improve the level of medical security, to ensure that the reasonable use of medical insurance funds, safe and controllable, and to promote the medical care, medical insurance, medicine, "three medical" reform. To better protect the people's medical needs, reduce the burden of medical costs.
(xi) and the county health committee of the division of responsibilities. The county health committee, the county medical security bureau and other departments in the medical, medical insurance, medicine and other aspects of strengthening the system, policy convergence, the establishment of a communication and consultation mechanism, collaborative promotion of the reform, improve the efficiency of the use of medical resources and the level of medical protection.
Internal organization
(I) Office. Responsible for the day-to-day operation of the organ, undertake the party and group work of the organ and affiliated institutions, undertake personnel management, organization and preparation, education and training and team building of the organ and affiliated institutions. It organizes the formulation of work planning, and undertakes the work of budgeting, asset management, internal auditing and statistical management of the organ and affiliated institutions. Undertake the review of the legality of normative documents of the organs, administrative reconsideration, administrative appeals and other work.
(2) treatment security and medical services management unit. Implementation of provincial and municipal medical insurance financing and treatment policies, drafting local policies and standards, and coordinating and promoting the construction of the county's multi-level medical insurance system. Establish and improve the medical insurance relationship transfer and succession system. Organize and carry out medical assistance. Implement the provincial and municipal long-term care insurance system reform programs. Implement the provincial and municipal medical insurance catalogs and payment standards, and implement the medical insurance agreement and payment management of designated medical institutions, and the management methods and settlement policies for medical treatment in other places. Promoting the construction of information technology and the reform of health insurance payment methods.
(3) fund supervision and bidding and procurement unit. Carry out the implementation of fund supervision and management methods, prepare the draft budget of the fund, establish and improve the safety and control mechanism of the county's medical insurance fund, credit evaluation system and information disclosure system. It supervises and manages medical service behaviors and medical expenses included in the scope of medical insurance payment, accepts complaints and reports in the field of medical insurance, and investigates and handles violations of laws and regulations in accordance with the law. Implement provincial and municipal price and fee policies, and establish a dynamic adjustment mechanism. Organize and carry out economic evaluation of drugs, medical consumables and medical technology under the responsibility of the county, and establish a system of price information monitoring and information release. Implement the bidding and purchasing, distribution and settlement management policies for drugs and medical consumables and supervise their implementation. Responsible for the organization and coordination of livelihood projects within the scope of responsibility.