Recently, the National Health Insurance Administration, together with the Ministry of Finance, the Health Commission, and the Administration of Traditional Chinese Medicine, jointly issued the "Notice on Carrying out Unannounced Inspections of the Medical Security Fund in 2024". The issuance of this notice marks that the supervision of the mainland medical security fund will enter a new stage, and the compliance and effectiveness of the use of the medical insurance fund will be ensured by more strict and standardized unannounced inspections.
As a surprise and efficient means of supervision, unannounced inspection has the characteristics of unpredictability and strong targeting. Through unannounced inspections, problems in the use of medical insurance funds can be found and solved in a timely manner, medical insurance fraud can be effectively prevented and combated, and the safe and sustainable use of medical insurance funds can be guaranteed.
The issuance of this notice clarifies the specific matters such as the object, scope, time and method of unannounced inspections, and requires medical insurance departments and relevant institutions at all levels to actively cooperate to ensure the smooth progress of the inspection work. At the same time, the circular also emphasized the strictness and fairness of the inspection work, requiring the inspectors to abide by discipline, strictly implement the inspection procedures, and ensure the authenticity and accuracy of the inspection results.
As far as the inspected units are concerned, they should attach great importance to the unannounced inspection work, actively cooperate with the work of the inspectors, conscientiously self-examine and self-correct, and rectify the existing problems in a timely manner. At the same time, internal management should also be strengthened, the system for the use of medical insurance funds should be improved, the efficiency of the use of medical insurance funds should be improved, and the compliance and effectiveness of medical insurance funds should be ensured.
The unannounced inspection will vigorously promote the healthy development of the mainland's medical security undertakings, improve the efficiency of the use of medical insurance funds, and protect the legitimate rights and interests of the vast number of insured personnel. At the same time, it will also promote the standardized management of medical insurance service providers such as medical institutions and pharmacies, improve service quality, and provide more high-quality and efficient medical services for the majority of insured personnel.
In short, the "Notice on Carrying out the Unannounced Inspection of the Medical Security Fund in 2024" issued by the National Health Insurance Bureau and other four departments is an important measure for the supervision of the medical security fund in the mainland.