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Hello! Recently, the Ministry of Human Resources and Social Security held a video conference on the basic medical insurance national network and direct settlement of medical treatment in other places, You Jun, vice minister of the Ministry of Human Resources and Social Security, to promote the direct settlement of hospitalization medical costs across provinces and other places to carry out a comprehensive deployment. The Ministry of Human Resources and Social Affairs signed a work responsibility letter with 22 provinces, including Beijing, that applied for the first batch of launching the national network of basic medical insurance and direct settlement of cross-provincial medical treatment.
National network and direct settlement for cross-provincial medical treatment
List of provinces for direct settlement
1. Beijing Municipal Bureau of Human Resources and Social Security
2. Tianjin Municipal Bureau of Human Resources and Social Security
3. Hebei Department of Human Resources and Social Security
4. Shanxi Province Department of Human Resources and Social Security
5. Liaoning Province Department of Human Resources and Social Security of Liaoning Province
6. Department of Human Resources and Social Security of Jilin Province
7. Department of Human Resources and Social Security of Heilongjiang Province
8. Department of Human Resources and Social Security of Jiangsu Province
9. Department of Human Resources and Social Security of Zhejiang Province
10. Department of Human Resources and Social Security of Henan Province
12.Department of Human Resources and Social Security of Henan Province
13.Department of Human Resources and Social Security of Hubei Province
14.Department of Human Resources and Social Security of Guangdong Province
15.Department of Human Resources and Social Security of Hainan Province
16.Chongqing Municipal Bureau of Human Resources and Social Security of Chongqing Municipality
17. Human Resources and Social Security Department of Sichuan Province
18. Human Resources and Social Security Department of Yunnan Province
19. Human Resources and Social Security Department of Shaanxi Province
20. Human Resources and Social Security Department of Ningxia Hui Autonomous Region
21. Human Resources and Social Security Department of Xinjiang Uygur Autonomous Region
22. Xinjiang Production and Construction Corps Bureau of Human Resources and Social Security
Seize the key time nodes
Highlight the key areas and tasks
Vice Minister Youjun emphasized that accelerating the promotion of the national network of basic medical insurance and the direct settlement of hospitalization medical expenses for cross-province medical treatment across the border is the overall deployment of the CPC Central Committee and the State Council, and that the State Council and the National People's Congress have made this work a key task and supervision this year The State Council and the National People's Congress have listed this work as a key task and supervision this year. Accelerate the national network settlement of medical insurance, to ensure the completion of the target task on schedule, is our major initiative to implement the central decision-making, is to firmly establish the four awareness of the inevitable requirements, is the ideological, political, action to maintain consistency with the CPC Central Committee's specific embodiment.
Vice Minister Youjun pointed out that the on-line of the national settlement system for medical treatment in different places and the introduction of the Notice on Doing a Good Job of Direct Settlement of Inpatient Medical Expenses for Medical Treatment in Different Places across Provinces of Basic Medical Insurance marked that the work of direct settlement of medical treatment for medical treatment in different places across provinces has been formally shifted from the stage of policy formulation and system development to the new stage of implementation of the policy, docking between the ministries and provinces of the system and the trial operation of the operation of the operation, and entered the crucial stage of focusing on the fight of the war. It has entered the critical stage of focusing on the battle. As time is tight and the task is heavy, it is necessary to adhere to the goal-oriented and problem-oriented approach, seize the three key time nodes at the end of this year, the two sessions of next year and the end of next year, highlight the key areas where medical treatment is concentrated such as Beijing, Tianjin, Hebei, Shanghai and Guangzhou, highlight the key tasks such as personnel filing, system docking, pre-payment allocation, and the national common use of social security cards, and back up the time to concentrate on attacking the problem and make good preparations for the start-up of the task, so as to ensure that the goals and tasks will be completed on schedule. Completion on schedule. We should fully consider the complexity and systematic nature of the settlement of medical treatment in other places, grasp the relationship between the management of medical treatment in other places and the settlement of expenses, focus on combining with the promotion of the construction of a graded diagnosis and treatment system, grasp the relationship between the management of the place of medical treatment and the management of the place of insurance, and grasp the integration of the national medical insurance networking project and the local management and management issues, so as to ensure that the work of the medical treatment in other places is highly efficient and smooth, smooth and smooth and safe.
Seizing the key without disconnecting
Vice Minister You Jun emphasized that the direct settlement of cross-provincial cross-district medical treatment involves policy measures, management system, standards and norms, operation mechanism, and information system construction, and involves the flow of personnel, business flow, fund flow, and information flow can be smooth, which a problem, will have a direct impact on the overall function to achieve. To effectively enhance the importance of this work, urgency, systematic and complexity of the understanding, bite the target does not relax, grasp the key not out of step, the key issues, especially the relationship between the public demand is not slow, the possible problems and difficulties do not avoid not panic, the overall situation, politics, science, dedication, to ensure that the tasks are completed on schedule.
You Jun, vice minister, pointed out that the economic and social development and medical technology levels vary greatly from place to place, and the health insurance policy norms, management service capabilities, and information technology levels vary, and the policy formulation should be compatible with the differences from place to place, and the handling process should be realized efficiently and conveniently, and the transmission of information should be balanced in terms of precision and efficiency. Human resources and social departments at all levels should take a high sense of responsibility and mission, and effectively unify their thoughts and actions to the central decision-making and deployment. It is necessary to clarify the time nodes, grasp the supervision, promote the implementation, implement the responsibility of supervision, strengthen the supervision and assessment, improve the execution, and ensure that the task is on the ground. It is necessary to improve the management and service capacity of the administration, and pay attention to the standardization of construction, and gradually unify the national medical settlement code. Risk assessment should be carried out simultaneously, and attention should be paid to summarizing the problems found in the direct settlement of medical treatment in other places, studying measures to solve them and reporting them in a timely manner. We should do a good job of publicity through multiple channels and angles to create a favorable atmosphere, guide reasonable expectations in a timely manner, and gain understanding and support. All localities should work according to the immediate tasks, backward schedule, and focus on tackling the problems, so as to meet the victory of the 19th CPC National Congress with excellent achievements.
Clear policy, clarify the responsibility
Ensure the completion of the target task
Social Security Center Tang Jisong, director of the policy interpretation, requires adherence to the norms and convenient, step-by-step, orderly access to medical care, unified management principles, to promote the direct settlement of hospitalization medical expenses across provinces. It clarifies the personnel and payment scope, treatment policy, prepayment policy, clearing policy, information transmission requirements, management policy, and clarifies the responsibilities of various levels such as the ministerial level, provincial level, and municipal level, so as to ensure the completion of the target task of direct settlement of hospitalization expenses for cross-provincial cross-district medical treatment.
By the end of 2016, the national network was basically realized, and the direct settlement of hospitalization medical expenses for retirees resettled in different places across provinces was initiated; direct settlement of hospitalization medical expenses for retirees resettled in different places across provinces was gradually resolved in 2017, and the direct settlement of hospitalization medical expenses for persons residing in different places in compliance with referral provisions was expanded by the end of the year. In conjunction with the reform of the local household registration and residence permit system, the long-term residents of other places and permanent staff in other places are gradually included in the coverage of direct settlement of hospitalization medical fees for medical treatment in other places.