Ministry of human resources and social security: in 2016, the national network of medical insurance was basically realized, and by the end of 2017, the direct settlement of medical expenses of compliance personnel in different places was realized

Source: Yigu on the afternoon of December 13, 2016, the Ministry of human resources and social security held a press briefing on the Chinese government's winning the "International Social Security Association Social Security outstanding achievement award" At the meeting, Huang Huabo, deputy director of the social insurance management center of the Ministry of human resources and social security, said: In order to do this work well, the Ministry of human resources and social security has set up a leading group with the leader of the Department in charge as the group leader and the participation of the planning and finance department, medical insurance administration department, agency department, information department and other departments, as well as an office At the same time, it has set up special working groups such as agency and information department, formulated a work plan, defined the tasks, reversed the schedule, and focused on tackling key problems At present, it has made some major breakthroughs, It is mainly manifested in two aspects: first, on December 9, the Ministry of human resources and social security and the Ministry of Finance jointly issued the notice on doing a good job in the direct settlement of medical expenses for basic medical treatment in different provinces This is No 120, 2016 issued by the Ministry of human resources and social security This document should be feasible after repeatedly soliciting opinions and arguments from relevant parties The document defines the objectives and tasks, basic principles, main policies, settlement mode, handling procedures, ministerial platform, provincial platform responsibilities, as well as the construction of information system and other major issues Second, last week, the National Remote Medical settlement system passed the preliminary acceptance This marks the transition of this work from policy decision-making and system construction to policy implementation and trial operation of system department and province At the same time, we will strengthen local dispatching in Beijing, Tianjin, Hebei, Shanghai, Guangdong, etc., and urge all regions to realize cross regional medical insurance settlement within the province this year, and to make good preparations for docking with ministerial level systems The two ministries and commissions have jointly issued documents recently The goal is to basically realize national networking by the end of 2016, and start the work of direct settlement of inpatient medical expenses of cross provincial remote resettlement retirees In 2017, the direct settlement of inpatient medical expenses of cross provincial remote resettlement retirees will be gradually solved, and the direct settlement of inpatient medical expenses of cross provincial remote resettlement retirees will be expanded to that of personnel meeting the referral requirements by the end of the year At the same time, combined with the reform of local household registration and residence permit system, the long-term residents and permanent staff in different places are gradually included in the coverage of direct settlement of medical and hospitalization expenses in different places Document 120 also identifies four basic principles The first is to standardize and facilitate, insist on providing convenient and convenient settlement services for the insured personnel, and ensure that the insured personnel only need to pay the inpatient medical expenses borne by individuals according to the regulations, and other expenses shall be paid after being reviewed by the agency at the place of medical treatment and the medical institution at the place of medical treatment according to the agreement Second, step by step Adhere to the principle of "first in province, then across provinces", first in hospital, then out-patient, first off-site resettlement, then referral, first basic medical insurance, then supplementary insurance In combination with the actual situation of information system construction in different regions, priority should be given to connecting regions with centralized medical treatment in different regions, and direct settlement work should be promoted steadily and comprehensively Third, orderly medical treatment, adhere to the integration of urban and rural medical insurance system, and the promotion of hierarchical diagnosis and treatment system, establish a reasonable referral mechanism, and guide the insured to orderly medical treatment Fourth, unified management, adhere to the basic medical insurance employment policy, process, and settlement method in different places are basically stable, integrate the different places of medical treatment into the local agency, negotiate with the designated medical institutions, control the total amount, intelligent monitoring, management of medical insurance doctors, medical service quality supervision and other management areas.