The National Healthcare Security Administration issued the Interim Provisions on Administrative Punishment Procedures for Medical Security (hereinafter referred to as the "Procedural Provisions") by Order No. 4, which came into effect on July 15, 2021. The Procedural Provisions consist of 7 chapters and 62 articles, which comprehensively regulate the legislative purpose, legal basis, scope of application, basic principles, entrusted law enforcement, jurisdiction and application, ordinary procedures, summary procedures, enforcement and closure, time limit and service. In particular, clear time limit requirements are put forward for the details of the case filing stage, the investigation and evidence collection stage, the case handling decision, the implementation stage, and the closing and filing of the case, and higher requirements are put forward for the administrative law enforcement of medical security administrative law enforcement personnel.
The procedural provisions' expression of the time limit for administrative punishment involves multiple time limits for the implementation of the law in years, days, working days, and hours, and their legal connotations are different, which is easy to be confused in the actual law enforcement process. This paper uses the timeline of medical security administrative punishment to sort out the procedures of medical security law enforcement, and supplements the legal time with explanations, so as to clearly and systematically grasp the legal procedures and time limit requirements of medical security administrative punishment.
1. Prosecution period
Article 6: Where illegal acts are not discovered within two years, administrative penalties shall not be imposed, and where citizens' lives, health, and safety are involved and there are harmful consequences, the above-mentioned time limit shall be extended to five years.
The time period provided for in the preceding paragraph is calculated from the date on which the illegal conduct occurred, and where the illegal conduct is continuous or continuous, it is calculated from the date on which the conduct ends.
Legal basis: Article 202 of the Civil Code of the People's Republic of China: "If the period is calculated according to the year and month, the corresponding day of the maturity month shall be the last day of the period;
II. Acceptance Planning
Article 10: If a dispute arises between two or more medical administrative departments due to jurisdiction, it shall be settled through negotiation within seven working days from the date of occurrence of the dispute; if the negotiation fails, it shall be reported to the common medical security administrative department at the next higher level for designation of jurisdiction, or it may be directly designated by the common medical security department at the next higher level.
Article 14: The administrative department for medical security shall verify and decide whether to file a case within 15 working days from the date of discovery of clues of illegal acts found on the basis of supervision and inspection authority or through complaints, reports, transfers from other departments, or assignment by superiors.
Legal basis: The Legislative Technical Specifications (Trial) (1) issued by the Legislative Affairs Committee of the Standing Committee of the National People's Congress stipulates that "working days" do not include holidays (the same below).
3. Investigation and evidence collection
Article 26: When collecting evidence, the administrative department for medical security may, with the approval of the person in charge of the administrative department for medical security, register and store it in advance with the approval of the person in charge of the administrative department for medical security, and shall make a decision on disposition within seven working days.
If the situation is urgent and it is necessary to take measures for prior registration and preservation on the spot, the law enforcement personnel shall report to the person in charge of the administrative department for medical security within 24 hours and complete the approval formalities. If the administrative department for medical security finds that advance registration and preservation measures should not be employed, it shall be lifted immediately.
Article 29: If the administrative department for medical security fails to take measures to register and preserve the evidence of materials that may be transferred, concealed or lost, it shall take measures to seal them, and if measures are taken or lifted, they shall be approved by the person in charge of the administrative department for medical security.
If the situation is urgent and it is necessary to take advance registration and preservation measures on the spot, the law enforcement personnel shall report to the person in charge of the administrative department for medical security within 24 hours and complete the approval formalities. If the administrative department for medical security finds that advance registration and preservation measures should not be employed, it shall be lifted immediately.
Article 31: The period of sealing shall not exceed 30 days, and if the situation is complicated, it may be extended with the approval of the person in charge of the administrative department for medical security, but the extension period shall not exceed 30 days. Where a decision to extend the sealing is made, the parties shall be promptly notified in writing and the reasons explained.
Article 34: Where the administrative department for medical security needs the assistance of the medical department of another administrative region in the investigation and collection of evidence in the course of handling a case, it shall issue a written letter of assistance in the investigation. The medical security administrative department that is requested to assist in the investigation shall complete the investigation within 15 days from the date of receipt of the letter of assistance in the investigation. If it is necessary to postpone the completion or cannot be completed, the medical administrative department that submitted the request for assistance shall be notified before the expiration of the time limit.
Legal basis: The Legislative Technical Specifications (Trial) (1) issued by the Legislative Affairs Committee of the Standing Committee of the National People's Congress stipulates that "days" include holidays and are natural days (the same below).
Fourth, the legal review
Article 40: After the legislative affairs body receives the relevant materials, it shall complete the review within 10 working days. Where an extension is necessary due to special circumstances, it may be extended by 10 working days upon approval by the responsible person for the legislative affairs body, but must not exceed the legally-prescribed time limit.
V. Penalty Decisions
(1) Ordinary procedures
Article 45: A decision on the disposition of cases handled applying the ordinary procedures shall be made within 90 days of the date on which the case is filed. Where a decision cannot be made within the prescribed time limit due to the complexity of the case or other reasons, it may be extended for 30 days with the approval of the person in charge of the administrative department for medical security.
If the case is particularly complicated or there are other special circumstances, and a decision cannot be made after an extension, the person in charge of the administrative department for medical security shall collectively discuss whether to continue the extension, and if it is decided to continue the extension, a reasonable period of extension shall be determined at the same time, but the extension shall not exceed 60 days.
In the course of case handling, the time for testing, testing, appraisals, hearings, announcements, and expert reviews is not calculated as the time limit for handling the case referred to in the preceding paragraph.
Article 46: Administrative punishment decisions made by the administrative departments for medical security shall be disclosed in accordance with relevant provisions such as open government information and administrative law enforcement publicity systems. Where a public administrative punishment decision is changed, revoked, confirmed to be illegal or invalid in accordance with law, the administrative department for medical security shall change the relevant information on the administrative punishment decision and explain the reasons within three days.
(2) Simplified procedures
Article 51: Where the simplified procedures are applied to make an administrative punishment decision on the spot, the case-handling personnel shall report the punishment decision and related materials to the administrative department for medical security to which they belong for filing within 7 working days of making the administrative punishment decision.
Article 52: Where an administrative punishment decision is made on the spot in accordance with the provisions of this Law, in any of the following circumstances, case-handling personnel may collect fines on the spot:
(1) A fine of up to 100 RMB is given in accordance with law;
(2) It is difficult to enforce it after the fact that it is not collected on the spot.
Fines collected by case-handling personnel on the spot shall be handed over to the administrative department for medical security within 2 working days of the date on which the fine is collected, and the administrative department for medical security shall pay the fine to the designated bank within 2 working days.
6. Enforcement of administrative punishments
Article 55: If a party fails to perform an administrative penalty decision within the time limit, the administrative department for medical security that made the administrative penalty decision may take the following measures:
(1) Where fines are not paid when due, an additional fine of 3% of the amount of the fine is to be imposed for each day, and the amount of the additional fine must not exceed the amount of the fine.
(2) Apply to the people's court for compulsory enforcement in accordance with the provisions of the "Administrative Coercion Law of the People's Republic of China".
Where the administrative department for medical security approves the suspension or installment payment of fines, the period for applying to the people's court for compulsory enforcement is calculated from the date on which the period for suspending or paying fines in installments ends.
Legal basis: Article 67, paragraph 3 of the Administrative Punishment Law: The party concerned shall pay the fine at the designated bank or through the electronic payment system within 15 days from the date of receipt of the administrative penalty decision. Banks should accept fines and pay them directly to the state treasury. Note: The 15th day is a natural day, that is, a fine will be imposed from the 16th day.
Article 53 of the Administrative Coercion Law of the People's Republic of China: Where a party does not apply for administrative reconsideration or initiates an administrative lawsuit within the statutory time limit, and fails to perform the administrative decision, the administrative organ that does not have the power of administrative compulsory enforcement may apply to the people's court for compulsory enforcement in accordance with the provisions of this chapter within three months from the date of expiration of the time limit.
Article 58: The time limit shall be calculated in hours, days, months, and shall not be counted in the hour or day on which the period begins. The period does not include transit time. Where the last day after the expiration of the period is a statutory holiday, the first day after the statutory holiday shall be the expiration date.
Legal basis: Article 201 of the Civil Code Where the period is calculated according to the year, month and day, the day of the beginning is not counted, and it is calculated from the next day. Where the period is calculated on an hourly basis, it is calculated from the time provided for by law or agreed upon by the parties.
Article 202 Where the period is calculated on the basis of years and months, the corresponding day of the due month shall be the last day of the period;
Article 203:Where the last day of the period is a statutory holiday, the day following the end of the statutory holiday shall be the last day of the period. The cut-off time on the last day of the period is 24 o'clock;
Seven: Delivery of the decision
Article 59: The administrative punishment decision shall be handed over to the parties on the spot after it is announced, and if the personnel are not present, the administrative department for medical security shall deliver the administrative punishment decision to the parties within seven working days in accordance with the relevant provisions of the "Civil Procedure Law of the People's Republic of China".
Original title: Combing the time limit axis of medical security administrative punishment procedures
Author | Ren Chaoyang, Wuhan Dongxihu District Medical Security Bureau
Source | China Medical Insurance
Edit | Yang Zixuan, Liu Xinyu
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