Implementation of urban minimum living security medical care in Fuxin city ..

Notice of Fuxin Municipal People's Government on printing and distributing the measures for medical assistance for urban residents in Fuxin City

(Fufa [2006] No.57)

County, District People's governments, municipal government departments and provincial units:

"Fuxin urban residents medical assistance measures" has been discussed and passed by the forty-fourth executive meeting of the municipal government, and is hereby issued to you, please follow them carefully.

Measures of Fuxin Municipality on Medical Assistance for Urban Minimum Living Security Objects

Article 1 In order to effectively alleviate the basic medical difficulties of urban subsistence allowances, these measures are formulated in accordance with the spirit of the Notice of the General Office of the State Council on Forwarding the Opinions of the Ministry of Civil Affairs and other departments on Establishing the Pilot Work of Urban Medical Assistance System and the Notice of the General Office of Liaoning Provincial People's Government Forwarding the Opinions of the Provincial Civil Affairs Department and other departments on Further Improving the Urban Medical Assistance System, combined with the actual situation of our city.

Article 2 The implementation of the basic medical assistance system for the urban minimum living security object shall adhere to the principles of capabilities, best efforts, combination of government assistance with family self-help and preferential treatment of medical institutions, and openness, fairness and impartiality.

Article 3 The municipal government shall set up a leading group for urban low-income residents' medical assistance, and its office shall be located in the Civil Affairs Bureau, responsible for the daily management of urban medical assistance.

Article 4 The following departments of the municipal government shall perform the duties of medical assistance for urban residents:

(a) the municipal civil affairs department is responsible for comprehensive coordination, policy formulation, personnel training, supervision and inspection, policy publicity and other work;

(two) the municipal labor and social security department set up an internal organization in the medical insurance management center (the name of Guanshi) to undertake the medical assistance work for the minimum living guarantee object;

(three) the municipal health department is responsible for the supervision of medical service behavior, establish and improve the rules and regulations of medical assistance and conscientiously implement them;

(four) the municipal finance department is responsible for the collection, management, supervision and inspection of medical assistance funds and office funds.

The district civil affairs department is responsible for the identification and dynamic management of the minimum living security object.

Fifth who enjoy the treatment of urban subsistence allowances, and did not participate in the basic medical insurance for urban workers, are the object of medical assistance.

Sixth medical assistance for urban residents to implement outpatient assistance and hospitalization assistance in two forms:

(1) Outpatient assistance: If the minimum living allowance object is sick and needs treatment, it must be treated in a designated hospital and enjoy limited assistance according to the prescribed proportion;

(2) Hospitalization assistance: those who need hospitalization can be treated in designated hospitals according to their illness and enjoy limited assistance according to the prescribed proportion.

Article 7 Standards of assistance:

(1) Outpatient assistance standard: The maximum amount of assistance per person per year is 40 yuan (which can be enjoyed by family members) for the low-income residents who meet the conditions of outpatient medical assistance, and the excess will be fully borne by themselves when each person reaches the maximum amount of assistance per year.

(II) Hospitalization assistance standard: The minimum living allowance recipients who meet the requirements of hospitalization medical assistance shall be co-ordinated, with the maximum amount of assistance per person per year being 2,000 yuan, and the ratio of government assistance to the actual hospitalization medical expenses borne by individuals is 1: 1. When each person reaches the maximum amount of hospitalization assistance every year, the excess shall be borne by himself in full, and hospitalization assistance is limited to himself.

Article 8 Designated medical service institutions shall be implemented for the medical management of urban minimum medical assistance objects. Designated medical service institutions shall be determined by the civil affairs department in conjunction with the health, labor and social security departments, and put forward opinions according to the reasonable layout and actual work needs, and report to the leading group for medical assistance for urban residents. Designated medical service institutions are located in hospitals with complete medical infrastructure, meeting the basic requirements of medical assistance and meeting medical standards. The lowest medical assistance institution shall sign a service agreement with the designated medical service institution, and will designate hospitals. The list together with the agreement shall be submitted to the office of the leading group for medical assistance for urban residents.

Ninth designated medical service institutions use drugs in accordance with the provisions of the Notice on Printing and Distributing the Catalogue of Drugs for Basic Medical Insurance and Industrial Injury Insurance in Liaoning Province. Designated medical service institutions shall carry out medical assistance in strict accordance with these measures and relevant regulations, master medical assistance procedures, use drugs rationally, treat diseases, strive to reduce service costs, and ensure medical quality and safety.

Tenth relief objects to non designated hospitals, regardless of outpatient expenses and hospitalization expenses are not entitled to medical assistance.

Eleventh designated medical institutions to give the following preferential treatment to the relief object:

(a) Exemption from registration fees and examination fees;

(two) bed fees and surgical treatment fees for CT, MRI and color Doppler examination are charged at 90% of the prescribed price.

Article 12 When seeking medical treatment, the aided person shall go to the designated medical institution for medical treatment with low guarantee, household registration book, identity card and medical treatment manual. Designated medical institutions shall carefully check the certificates held by the recipients to ensure that the guarantor is consistent with the certificates.

Thirteenth for outpatient assistance, doctors according to the condition, according to the scope of basic drugs prescription (prescription stamped with the "minimum" chapter). The receipt is filled in according to the patient's own part and the second part of the relief. The receipt is in quadruplicate, one for the patient, one for the pharmacy, one for the stub and one for the fund settlement.

Fourteenth recipients need hospitalization, they should go to the designated hospital for hospitalization, and pay the hospitalization deposit according to their own proportion. Within the maximum amount of assistance, only the part that the individual should bear will be paid, and the rest will be paid in advance by the designated hospital, and all the parts beyond the maximum amount will be paid by the recipients. The prescription issued by the hospital should be stamped with the "minimum living guarantee" chapter. When the relief object is discharged from the hospital, the designated hospital shall record its actual hospitalization expenses and the remaining amount of relief in the Medical Manual.

Fifteenth rescue objects in case of acute disease can not be handled according to the normal rescue procedures, you can go to the nearest hospital for first aid, but after the first aid, you must promptly transfer to the designated hospital for hospitalization. If there are special circumstances that can't be transferred temporarily, you must go through the relevant formalities at the municipal labor and social security department (medical insurance center) and transfer to the designated hospital for treatment in time after the condition is stable. During hospitalization in non-designated hospitals, the expenses shall be paid in advance by the aid recipients, and the relevant departments shall go through the rescue procedures according to regulations after discharge.

Article 16 If the relief object really needs to be transferred to a non-designated hospital for treatment due to illness, the designated hospital shall put forward opinions, issue a certificate of transfer, and file with the municipal labor and social security department (medical insurance center) before being transferred to the corresponding hospital for treatment. Medical expenses shall be paid in advance by the aid recipients, and the relevant departments shall go through the rescue procedures according to the regulations after discharge.

Seventeenth medical assistance funds to raise the implementation of special government funds and social collection. The municipal and district finances shall be shared according to the ratio of 7: 3 (the insufficient part after the provincial special subsidy), and the funds to be borne by each district shall be deducted from the state treasury on a monthly basis and settled at the end of the year.

Article 18 The municipal and district civil affairs bureaus shall, jointly with the municipal finance, labor and social security departments, prepare the demand plan for medical assistance funds for the minimum living security object and the amount of funds to be borne at the same level at the beginning of each year, which shall be included in the annual budget after being audited by the government at the same level and reported to the people's congress at the same level for approval; The financial department shall timely allocate funds according to the budget and actual assistance needs. Municipal finance, labor and social security departments must establish a special account for urban residents' medical assistance funds, implement earmarking of medical assistance funds, implement total control, and carry forward the surplus funds to the next year for use, and shall not misappropriate them.

Nineteenth municipal finance according to the demand for medical assistance funds, medical assistance funds will be allocated to the municipal labor and social security departments of the special account for subsistence allowances before the 5th of each month.

Twentieth designated medical service institutions to rescue funds once a month. Designated hospitals (including those transferred to other hospitals) shall submit the hospitalization receipt, expense list, medical records, medical manuals, low guarantee, household registration book, copy of ID card and statistics to the municipal labor and social security department for settlement of last month's relief funds before 10. The expenses incurred by medical emergency patients before they are transferred to designated hospitals shall be settled according to the procedures of designated hospitals by the relevant procedures of emergency hospitalization.

Twenty-first designated medical service institutions shall bind the settlement data into a book and send it to the municipal labor and social security department (medical insurance center) and the health department for archival reference.

Article 22 The Office of the Leading Group for Urban Medical Assistance shall inspect the prescriptions, medical records, therapeutic effects, charging prices, approval of assistance bills, and fund settlement of designated medical institutions, and draw the relevant departments to deal with illegal acts severely according to law.

Twenty-third relevant departments must strengthen supervision and management, to ensure that all relief funds are used for relief objects, and to prevent illegal acts of misappropriation and misappropriation of relief funds.

Twenty-fourth governments at all levels should arrange the necessary working funds to ensure the normal development of medical assistance for urban residents.

Twenty-fifth staff engaged in urban medical assistance management should be impartial, and any of the following acts shall be criticized and educated and given administrative sanctions by the relevant departments; If the case constitutes a crime, criminal responsibility shall be investigated according to law:

(a) in violation of regulations to provide urban medical assistance to those who do not meet the conditions;

(2) embezzling or misappropriating relief funds.

Article 26 If the staff of designated medical institutions cheat relief funds by means of concealment or deception, the municipal labor and social security department and the public security organ shall recover the defrauded relief funds, and the relevant responsible persons shall be given administrative sanctions by their units or higher authorities; If a crime is constituted, criminal responsibility shall be investigated according to law.

Twenty-seventh abuse, assault city medical assistance management personnel or designated medical institutions staff, by the public security organs in accordance with the relevant provisions of punishment; If a crime is constituted, criminal responsibility shall be investigated according to law.

Twenty-eighth Fuxin Mongolian Autonomous County and Zhangwu County urban residents medical assistance can be implemented with reference to these measures.

Article 29 These Measures shall come into force on June 1 day, 2006.