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Human resources and social department: 2017 residents medical insurance personal payment standard increased by 30 yuan
RELEASE TIME:2017-07-04 BROWSE:3612

Notice of the Ministry of human resources and social security and the Ministry of Finance on doing well the work of basic medical insurance for urban residents in 2017

Ministry of human resources and social development [2017] No. 36

All provinces, autonomous regions, municipalities directly under the central government and the Xinjiang production and Construction Corps human resources and Social Security Bureau (bureau), Finance (trade) department (bureau), Fujian medical insurance office:

2017 is an important year for the implementation of the "13th Five-Year" plan. According to the CPC Central Committee and the State Council on promoting the basic medical insurance system, consolidate and improve the integration of urban and rural residents of urban and rural residents illness insurance, play an effective role in deepening the reform and construction of national health care health China effects of deployment requirements, is to do the work of the basic medical insurance for urban residents in 2017 (the basic medical insurance, including the Department of human resources and social security management of urban and rural residents below. Hereinafter referred to as the work of resident health insurance is as follows:

First, raise funding standards and enhance support capacity

(1) raising the standards for financial assistance. In 2017, the per capita financial subsidy standards for residents at all levels of medical insurance increased by 30 yuan in 2016, reaching an average of 450 yuan per year. Among them, the central government grants subsidies to the western and central areas in accordance with the proportion of 80% and 60% respectively, and grants subsidies to provinces in the eastern region at a certain rate. Provincial finance should increase the intensity of the difficult areas, and further improve the provincial and the following financial sharing measures. In accordance with the "Notice of the State Council on the implementation of support for the transfer of agricultural population of people some fiscal policy" (Guo Fa 2016 No. 44), to hold a residence permit and the insured according to the same standard payment according to local residents the same standard grant.

(two) strengthen individual payment collection. In 2017, the average per capita payment of medical insurance for urban and rural residents was raised by 30 yuan on 2016, with an average of 180 yuan per person per year. Localities should increase publicity and guidance, and strengthen personal contributions collection work. In accordance with the "notice on Further Strengthening the medical assistance and the urban and rural residents illness insurance effectively" (min FA 2017 No. 12), to fully implement the policy funding difficulties of the masses, to ensure that the poor people, living object, participatory poverty difficult personnel into the resident medical insurance and critical illness insurance.

Two, speed up integration and promote fair and sustainable development

(three) establishing a unified system. All localities should continue to step up efforts to integrate the basic medical insurance system for urban and rural residents. Efforts should be made to supervise, guide and co-ordinate the regional planning and deployment at the provincial level. As soon as possible, a detailed implementation plan for the integration system will be formulated. Focus on the integration of the system of policy, straighten out the management system, the implementation of the integration of management and other aspects, the overall order to do the integration work, to achieve a smooth system of urban and rural insurance, basic medical insurance system in 2017 and strive to basically establish a unified urban and rural residents. In the process of integration, individual payment should be carried out in the overall planning area, and the lowest level should not be lower than the national standards.

(four) promoting integration effect. To break the division between urban and rural areas, the implementation of the national insurance plan, so as to ensure the protection of the insured, to promote continuous insurance, to prevent repeated insured, repeated subsidies, repeated construction. Balancing the treatment level of urban and rural residents, ensuring the basic medical treatment, fair and inclusive, and enhancing the people's sense of access. Raise the overall planning level, strengthen mutual aid and ability to resist risks, and improve the level of fair, reasonable and orderly utilization of medical services among the residents. Fully relying on the existing management foundation, effectively integrate resources, implement integrated operation, and steadily improve service efficiency. Make full use of the unified management advantages of the whole people's medical insurance, and give better play to the fundamental role of deepening medical reform and building a healthy China, and promote the realization of the "three medical linkage"".

Three, improve the serious illness insurance, help poverty alleviation

(five) implement accurate payment. All localities should implement the central poverty alleviation strategy deployment, in-depth implementation of health poverty alleviation project, focusing on rural poverty in participatory and improve the serious illness insurance, strengthen underpinning security. On the basis of raising the standard of the residents' medical insurance funding, and according to the provisions of individual payment subsidies for difficult groups, reasonably determine the financing standards for serious illness insurance, and strengthen the insurance support ability for serious illness insurance. Serious illness insurance to increase difficult personnel policy, by lowering the threshold and increase the proportion of reimbursement to implement accurate payment policy, and effectively improve the poor benefit level. To perfect the serious illness insurance commission contract, and strengthen the commercial insurance company policy implementation assessment and supervision.

(six) do a good job of institutional cohesion. All localities should further strengthen the illness insurance and medical assistance effectively, focus on the formation of security force in the security object and payment policy, strengthen the poverty relief underpinning security chain construction, effectively prevent the occurrence of poverty caused by illness issues. We will strengthen basic medical insurance, serious illness insurance, medical aid and management cooperation, and make full use of the basic medical insurance management information system to provide "one-stop" instant settlement services for insured persons. We will improve the statistical analysis of serious illness insurance, strengthen the operation and supervision of serious illness insurance, urge the contractors to strengthen cost control, strictly fund the use and Realization of immediate settlement, and submit the operation according to the requirements.

Four, strengthen management and supervision, to prevent operational risk

(seven) perfect service supervision. Around the need to comprehensively deepen the reform of payment methods and implementation of intelligent monitoring medical insurance as an opportunity to improve the security and control from both the increase in the cost of medical insurance for medical services, strengthen supervision and management of suppliers. To pay the total control as the basis for the implementation of complex diseases, according to pay according to the number of people in various ways such as combination, perfect negotiation, risk sharing and incentive mechanism, promote medical institutions initiative to standardize the medical service and medical service cost control. As the basis to improve the basic medical insurance management information system, the implementation of the Medicare physician management as the basis, explore the effective way to extend services to the regulatory focus on the behavior of medical staff, the medical service behavior through the designated institutions in advance to remind, post audit monitoring throughout the implementation of real time monitoring, in violation of laws and regulations, increase the punishment, breach of contract.

(eight) strengthening early warning of funds. Agencies at all levels should strengthen the awareness of risk prevention and establish a sound management and supervision mechanism for fund operation. We will co-ordinate the basic medical insurance and serious illness insurance, improve the budget management of Fund revenues and expenditures, improve the fund operation analysis system, and strengthen the risk monitoring of non payment and non payment of funds. We will strengthen the designated medical institutions, rationally control medical expenses, supervise and assess, and strictly manage fund expenditures. Establish and improve the risk early warning, assessment, resolution mechanisms and plans, for problems and risks, early judgment, comprehensive policy, clear the main body, responsibility in place, nip in the bud.

Five, strengthen publicity and guidance, and stabilize social expectations

(nine) building a good atmosphere. Do a good job in 2017 residents medical insurance work, involving the vital interests of the masses, related to social stability. Human resources, social security departments and financial departments at all levels should attach great importance to and closely cooperate with each other, pay attention to strengthening publicity, guidance and public opinion monitoring, accurately interpret policies, reasonably guide expectations, and do a good job of risk response. The major problems encountered in the course of implementation shall be reported to the Ministry of human resources and social security and the Ministry of Finance in a timely manner.

Ministry of human resources and social security

Treasury Department

April 24, 2017