1. In order to adapt to the establishment of the socialist market economic system and improve the health of workers, the reform of the public medical system to take a positive and steady, step by step in place, and gradually to the establishment of a social medical insurance system combining the social coordinated medical fund and individual medical accounts.
2. Provide basic medical protection for the employees of the provincial units, prevent the waste of medicine, and gradually realize the optimal allocation and rational use of health resources, in order to facilitate the formation of a more complete social security system.
3. The level and manner of basic medical protection are compatible with the level of development of social productive forces in the province and the affordability of all parties, and the state, units and employees reasonably bear the medical expenses, and enhance the awareness of the costs of units and individuals.
4. Fairness and efficiency are combined, and the basic medical insurance benefits enjoyed by employees are appropriately linked to their individual contributions to society, so as to help mobilize the enthusiasm of employees.
5. The establishment of a mechanism of constraints on both doctors and patients, giving full play to the sentinel hospitals, enjoyment units and enjoyment *** with the enthusiasm to participate in the management of the medical institutions to promote the deepening of reforms, strengthen internal management, improve the quality of medical services and efficiency, and curb waste. Article 2 the raising and distribution of public medical expenses
1. Provincial units directly under the public medical expenses included in the provincial budget, by the provincial health department of public medical management office (hereinafter referred to as the public medical office) in accordance with the provisions of the arrangements for the use of public medical expenses.
2. In compliance with the "Chinese people's *** and the State Teachers Law", teachers enjoy the same medical treatment as national civil servants in the spirit of colleges and universities and medical and other units are still the implementation of the public medical expenses reasonable quota lump sum management approach, the quota standard in accordance with the relevant provisions of the implementation of the unit lump sum co-ordination of outpatient, inpatient medical care, and the balance of the retention of the overspending will not be compensated for.
3. Provincial organs hospitals and provincial people's hospitals within the scope of the enjoyment of the public medical expenses of the medical unit of the medical expenses of the trip, still by the original standard allocated to the unit of the use of the lump sum.
4. Publicly-funded medical expenses shall be allocated by the Provincial Department of Finance to the Public Medical Office of the Provincial Department of Health on a monthly basis, and then by the Public Medical Office to the relevant units and relevant hospitals. Article 3 Management of Publicly-funded Medical Treatment
1. The Publicly-funded Medical Treatment Management Committee for Provincial Directly-affiliated Units was established, with an office (i.e., the Publicly-funded Medical Treatment Management Office of the Provincial Health Department) responsible for the management of publicly-funded medical treatment for the provincial organs and directly-affiliated units. At present, it is still managed in accordance with the scope of management of provincial organs hospitals and provincial people's hospitals in the fixed division of labor as determined by the provincial health department and the provincial finance department in 1993.
2. Public medical office and designated medical units should seriously implement the "prevention-oriented" policy, and actively carry out health education and physical examination, for early detection, early treatment of tumors, hepatitis, cardiovascular and cerebrovascular diseases and other major diseases, enjoy the public medical personnel every two years for a physical examination, and the implementation of the necessary tracking of patients with serious illnesses. The funds required for medical examinations are spent in accordance with the original channels.
3. In order to reduce the waste and strengthen the supervision and control, the employees must present the medical records with their own photos to the designated hospitals by the Office of the Public Medical Service, and all those who go to the non-designated hospitals after the approval of the Office of the Public Medical Service will pay for the treatment by themselves first and then go back to the Office of the Public Medical Service to be certified according to the regulations.
4. The prescription of medical treatment is limited to 3 days for acute diseases and 10 days for chronic diseases. In order to be responsible for the patient's condition, it is not permitted to entrust the prescription of drugs. Self-financed medicines should be prescribed separately, and the cost of the medicines should be borne by the patient.
5. If the cost of organ transplantation and large-scale precision instrument examination and treatment is more than 200 yuan, the unit shall bear 15%, the employee shall bear 5%, the retiree shall bear 2.5%, and the retiree shall not bear the cost, and the remaining part shall be reimbursed by the public medical expenses. Prior to the approval of the public medical department without direct management of all the costs of self-responsibility, emergency rescue can be examined and treated first, but must be made up within 10 days of the approval procedures. The medical expenses borne by the unit are charged to the welfare expenses and the normal budget of the unit.
6. Cadres enjoying health care objects to implement the fixed-point medical care. In-service and retired subjects in addition to the provincial organs of the hospital, are implemented in the provincial hospital, Fujian Medical University Concordia Hospital; Affiliated First Hospital, Fujian College of Traditional Chinese Medicine Affiliated People's Hospital, Affiliated Second People's Hospital and Fujian Provincial Geriatrics Hospital six hospitals, the nearest hospital of their choice for a fixed-point medical treatment; retired subjects in addition to the provincial organs of the hospital, can be in the six hospitals above In addition to the provincial government hospitals, the retired beneficiaries can receive medical treatment at two designated hospitals of their choice among the six hospitals mentioned above. Specialized medical records and systematic health files are set up by them and kept in a unified manner. If a health care recipient needs to go to a non-designated hospital for treatment due to his/her condition, he/she must be approved by the designated hospital, and the cost will be billed to the approved designated hospital.
7. The costs of registration, self-paid medicines, self-purchased therapeutic medicines without the approval of the Office of Public Health Care, special service items and other self-paid items, regardless of cadre level and category, shall be borne by the individual and shall not be reimbursed. Article IV of the cadres to enjoy the management of health care objects
1. enjoy the cadres to enjoy the object of health care is not implemented for the time being the medical fees and personal linkage, the implementation of the determination of a reasonable annual medical fee fixed standard by the designated hospitals to coordinate the management of the use of the hospitals.
2. The designated hospitals to strengthen management and improve the quality of medical services. According to the health care object physical condition to ensure the rational use of drugs, reasonable examination, eliminate waste. Shall not reduce the quality of medical care due to the cost of the integrated package, otherwise the leadership of the hospital will be held responsible.
3. The year-end balance of medical expenses of the designated hospitals, after review by the public medical management department to give a certain percentage of incentives for the designated hospitals to purchase or update medical equipment, but also can be extracted from a certain percentage of the incentives to the relevant medical personnel, but for individual incentives part of the maximum amount shall not exceed the incentive of 30%. The rest of the medical fees shall be transferred to the fixed medical fees of the following year.
4. According to the quota approved by the fixed hospital annual medical cost overruns, in principle, the finance will not be allocated to compensate, such as stroke rescue, malignant tumors in the late stages of a larger breakthrough than usual and caused by the annual quota of medical cost overruns, the verification of the appropriate subsidies, but belongs to the out-of-pocket expenses for medicines, duplication of tests, irregularities in the use of medicines part of the burden should be borne by the hospital.