Heavy | Jining Municipal People's Government's notice on further improving the level of medical security

Jining City People's Government

Notice on further improving the level of medical security

The people's governments of counties (cities, districts), Jining High -tech Zone, Tai Baihu New District, Jining Economic and Technological Development Zone, Qufu Cultural Construction Demonstration Zone Management Committee (Promoting Office), Municipal Government departments, major enterprises, and colleges and universities in colleges and universities The

The municipal government will be listed as private affairs this year. In order to accelerate the implementation of the actual affairs of private affairs and further reduce the burden of personal medical expenses, in accordance with the "Opinions of the People's Government of the Shandong Provincial Party Committee of the Communist Party of China on the implementation of the" Opinions of the Central Committee of the Communist Party of China on Deepening the Reform of the Medical Security System " 〕 No. 18) and other regulations to further improve the city's medical security treatment. The relevant matters are notified as follows:

1. Improve medical security treatment

(1) Increase the proportion of residents' medical insurance reimbursement. Insurance residents' payment ratio of hospitalization medical expenses in hospitals in the first and secondary medical institutions increased by 5%, respectively from 80%and 70%to 85%and 75%, respectively.

(2) Improve the maximum payment limit of employee medical insurance. The maximum payment limit of employee medical insurance has been increased from 1.25 million yuan to 1.45 million yuan, of which the maximum payment limit for basic medical insurance has been increased from 100,000 yuan to 150,000 yuan, and large medical expenses subsidies for employees (former municipal major disease insurance) increased from 350,000 yuan To 500,000 yuan.

2. Relevant requirements

(1) Ensure that the policy is effective. Medical insurance, health and health and other departments at all levels should earnestly implement policy implementation, and timely update the content of policy adjustment on the medical insurance system, realize the instant settlement of medical institutions, and allow the masses to enjoy medical insurance treatment as soon as possible. It is necessary to do a good job of publicity and guidance. Through various methods such as public accounts, websites, radio and television, etc., the vivid forms such as illustration, audio, and animation are used in all -round, multi -angle, and three -dimensional development of personalized information promotion.

(2) It is necessary to strengthen the coordination of the department. Relevant departments such as medical insurance, health and health should strengthen cooperation and cooperation, and strengthen the coordination and comprehensive supporting facilities between medical insurance, medical care, and medical system policies. The medical insurance department is responsible for coordinating the reform of the medical security system, and in conjunction with relevant departments to study and solve the problems of cross -departments, cross -regions, and industries during the reform, and timely settle and allocate fixed -point medical institution funds. The health department should strengthen the management and supervision of medical institutions, optimize the medical process, and improve the level of medical services. The financial department should do a good job of funding, strengthen fund supervision and inspection, and standardize the fund's preparation and calculation system.

(3) The supervision of the medical insurance fund should be strengthened. In -depth analysis and research on the key points, difficulties and breakthroughs of the fund supervision, and carry out "dual random and one open" inspection activities. The medical insurance department must investigate and verify the suspected clues in conjunction with the public security department, and severely crack down on fraudulent medical insurance funds in accordance with the law. It is necessary to strive to build a long -term governance mechanism for cracking fraud and insurance for the construction of the architectural fence, source prevention, and full -process supervision to ensure the safe operation of the medical insurance fund.

Jining City People's Government

August 4, 2022

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