Source: China News Network
Nanning, 20 Jan (China News Network) -- The medical security fund is the people's "medical treatment money" and "life-saving money." Wang Zhongping, secretary of the party group and director of the Guangxi Zhuang Autonomous Region Medical Security Bureau, introduced on the 20th that in 2021, Guangxi inspected a total of 14,386 designated medical institutions, investigated and punished 9,517, dealt with 562 individuals who violated laws and regulations, and recovered (including refusal to pay) medical insurance funds of 1.212 billion yuan.
Wang Zhongping was interviewed by China News Network on the same day and introduced that the Guangxi Medical Security Bureau has gradually formed and continued to consolidate the high-pressure situation of fund supervision in the whole region through a series of measures such as "heavy innovation, full coverage, diligent exposure, cohesion, and construction of mechanisms".
According to reports, Guangxi relies on the "Internet + supervision" model to establish a hospitalization scene monitoring, drug purchase monitoring, and the whole process of intelligent supervision platform, and create a new model of "double integration" governance of medical insurance and hospital fund supervision. As a pilot area for the innovation of the supervision mode of the national medical insurance fund, Guangxi was rated as "excellent" in the final evaluation organized by the state.
Guangxi has compacted local regulatory responsibilities, organized medical insurance departments at all levels to carry out full-coverage inspections of designated medical institutions within its jurisdiction by carrying out special governance of medical chaos, implementing zero-clearance actions, and cracking down on the special rectification of "three fakes", etc., to ensure that there are no "loopholes" in supervision and no "dead ends" in inspections. At the same time, strengthen the publicity of fund supervision and the exposure of typical cases, and improve the system of reporting complaints and exposure. In 2021, 1,006 typical cases were exposed in the whole district, and medical insurance departments at all levels cashed out a reward of 153,900 yuan to informants of fraud and insurance fraud.
In addition, the Guangxi medical insurance department strengthened cooperation with public security, health and other departments, gave full play to the complementary role of departmental advantages, and strengthened the comprehensive supervision and control of departments. At the same time, it actively docks with the Political and Legal Committee of Guangxi Zhuang Autonomous Region, promotes the "grid management" of medical insurance fund supervision throughout the region, and builds a fund supervision system of "horizontal to the edge and vertical to the end".
Wang Zhongping said that Guangxi has established and improved the fund supervision system, promoted the reform of the medical insurance fund supervision system system, formulated work methods for transferring clues to the discipline inspection and supervision organs, standardized the approval of the amount of medical insurance funds used in violation of regulations, and established a comprehensive supervision and coordination work mechanism and a joint conference system for medical insurance fund supervision.
As of the end of December 2021, Guangxi's basic medical insurance has insured 52.66 million people, the participation rate has been stable at more than 97%, the reimbursement ratio within the policy scope of employee medical insurance and resident medical insurance has reached 85.87% and 73.81% respectively, the rolling balance of the employee medical insurance fund can be paid for 24 months, the rolling balance of the urban and rural residents' medical insurance fund can be paid for 11 months, the operation of the fund is safe and stable, and the goal of basic medical insurance for the whole people is basically realized. (End)
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