Interim Measures for the Management of Urban Workers' Basic Medical Insurance Designated Medical Institutions in Xi'an City

Article 1 In order to strengthen and standardize the management of designated medical institutions for basic medical insurance for urban workers, these Measures are formulated in accordance with the Interim Measures of the Ministry of Labor and Social Security, the Ministry of Health, and the State Administration of Traditional Chinese Medicine on the Management of Designated Medical Institutions for Basic Medical Insurance for Urban Workers and Interim Measures for Basic Medical Insurance for Urban Workers of the Municipality of Xi'an. Article 2 The fixed-point medical institutions referred to in these Measures refer to the medical institutions that provide medical services to the participants of the basic medical insurance for urban workers, which are examined by the municipal labor administrative department and determined by the municipal medical insurance agency. Article 3 The principles of the review and determination of the fixed-point medical institutions are: to facilitate access to medical care for employees, easy to manage; to take into account the specialties and comprehensive, traditional Chinese medicine and Western medicine, focusing on giving full play to the role of community health service institutions; to promote the optimal allocation of health care resources, improve the efficiency of the use of health care resources, and reasonably control the cost of health care and improve the quality of health care services. Article 4 The following categories of medical institutions approved by the administrative department of health and obtaining the "license for practice of medical institutions", as well as military medical institutions approved by the competent department of the army qualified to carry out external services, can apply for the qualification of fixed-point:

(1) general hospitals, hospitals of traditional Chinese medicine, Chinese and Western medicine hospitals, hospitals of ethnic medicine, specialized hospitals, emergency institutions;

(2) centers of Health centers, township (township) health centers, street health centers, maternal and child health centers (institutes);

(C) comprehensive outpatient clinics, specialized outpatient clinics, Chinese medicine outpatient clinics, combined Chinese and Western medicine outpatient clinics, outpatient clinics of ethnomedicine;

(D) clinics, clinics of traditional Chinese medicine, clinics of ethnomedicine, clinics, clinics;

(E) specialized disease prevention and treatment hospitals (institutes, stations);

(F) approved by the municipal health administrative departments set up by the community health service organizations. Article 5 The fixed-point medical institutions shall have the following conditions:

(1) in line with the regional medical institutions set up planning;

(2) in line with the standards for the accreditation of medical institutions;

(3) comply with the national laws, regulations and standards relating to the management of health care services, there are sound and perfect medical service management system;

(4) strict implementation of national, provincial and municipal The price policy of medical services and medicines stipulated by the price department is qualified by the price department's supervision and inspection;

(e) Strictly implementing the relevant policies and regulations of the basic medical insurance system for urban workers, setting up specialized institutions for the basic medical insurance services and equipping them with necessary management personnel, and equipped with the capability and conditions of microcomputer networking. Article 6 A medical institution willing to undertake the designated services of basic medical insurance for urban workers shall submit a written application to the municipal labor administration department and provide the following materials:

(1) a copy of the license to practice and its copy;

(2) the certificate of legal personality;

(3) a list of large-scale medical instruments and equipments;

(4) number of employees, number of various types of professional and technical personnel, and the structure of their titles. (d) the number of employees, the number of various types of professional and technical personnel, and the structure of their titles;

(e) the business income and expenditure and the volume of outpatient and inpatient treatment services in the previous three years (including the number of outpatient treatment visits, the average medical fee per treatment visit, the number of inpatient hospitalizations, the average number of hospital days for discharged inpatients, the average inpatient medical fee per discharged inpatient hospitalization, the average daily inpatient medical fee per discharged inpatient hospitalization, and so forth), and the capability of assuming the services of the medical insurance;

(vi) documents proving compliance with the accreditation standards for medical institutions;

(vii) documents proving that the drug supervision and management and pricing departments have passed the supervision and inspection;

Medical institutions applying for the first time are required to submit the documents specified in (viii) and (ix).

(viii) the following statements for the year of application deferred forward three years:

1. Comprehensive Statistical Table for Primary Health Care Units - Table 1 (Table 1-11 of the Health Statistics 1);

2. Comprehensive Statistical Table for Primary Health Care Units - Table 2 (Table 1-5 of the Health Statistics 2);

3.

3. Annual report on the personnel of clinics and health care clinics (Table 4 of the GHS);

4. Annual report on the classification of diseases of inpatients in health sector hospitals (Table 3 of the GHS);

5. Questionnaire on discharged patients from hospitals in the health sector (Table 33 of the GHS).

(ix) 1998 or the application year of the previous year's monthly and quarterly reports:

1. Hospitals, health centers, hospital beds and patient dynamics of the monthly, quarterly and annual statements;

2. Health sector hospitals, hospitals, inpatient disease classification of the monthly, quarterly and annual statements;

3. Health sector, county and above the county hospitals, and the funding, revenue and expenditure of the monthly, quarterly, and annual statements;

4. Monthly, quarterly and annual statements of the medical expenses of hospitalized patients for some diseases in the hospitals of the health departments. Article 7 the municipal labor administration department according to the application of the medical institutions and the materials provided by the medical institutions for review, the review of qualified medical institutions issued by the designated certificate of qualification, and announced to the community for the insured employees to choose. Article 8 In the medical institutions which have obtained the qualification of designated service, the employees shall put forward their intention of choosing designated medical institutions for medical treatment, which shall be summarized by their units and uniformly submitted to the municipal medical insurance agency. The municipal health insurance agency shall determine the fixed-point medical institutions in accordance with the employees' intention to choose. Article 9 Specialized medical institutions and Chinese medical institutions (including combined Chinese and Western medical institutions and ethnomedical institutions) that have obtained the qualification of designated service can be used as the designated medical institutions for the insured employees.

In addition to the above two types of medical institutions, the employees can generally choose another 3-5 medical institutions at different levels, including 1-2 primary medical institutions (including first-level hospitals, Chinese and Western medicine combined medical institutions, ethnomedicine medical institutions, and various types of health centers, institutes, and rooms); 1-2 second-level hospitals, 1-2 second-level hospitals, 1-2 second-level hospitals, 1-2 second-level hospitals, 1-2 second-level hospitals, and 1-2 second-level hospitals. -2 second-level hospitals, 1-2 third-level hospitals.