Pastoral area promotes new rural medical cooperation work program
In order to implement the "Decision of the Central Committee of the Communist Party of China and the State Council on Strengthening Rural Health Work in the New Rural Pastoral Area Cooperative Medical Work Plan of Bahrain Zuoqi" and the "Notice of the General Office of the State Council on Forwarding the Opinions of the Ministry of Health and Other Departments on Establishing a New Rural Cooperative Medical System" and The Inner Mongolia Autonomous Region People's Government Office of the People's Government of the People's Republic of China on Printing and Distributing the Work Plan for the New Rural Pastoral Area Cooperative Medical Work Program and other related archives spirits shall be formulated in accordance with the relevant requirements of the pilot work of the new rural rural pastoral cooperative medical service in the State, the autonomous region and Chifeng City.
I. Guiding ideology, guidelines, objectives, mission guiding ideology, and guidelines for doing a good job in the cooperative work of the new rural pastoral areas must be guided by the important thinking of the "Three Represents" and the spirit of the Sixth Plenary Session of the 16th CPC Central Committee to strengthen leadership and increase investment. Prepare carefully; proceed from the actual situation, adapt to local conditions, respect the wishes of farmers and herdsmen; coordinate urban and rural development, promote social equity, solve the problem of lack of medical care and medical treatment in rural pastoral areas; increase efforts to accelerate the promotion of new rural pastoral cooperative medical care system The pace of construction; the interests of farmers and herdsmen must be put first, improve services, improve quality, and ensure the benefits of farmers and herdsmen.
Objectives and tasks Actively research and explore new rural pastoral cooperative medical policy measures, operational mechanisms, service systems and supervision methods that adapt to the level of social and economic development of our flag, the economic endurance of farmers and herdsmen, and the supply and demand of medical services. In XX, in accordance with the requirements of the people's government of the autonomous region, the new rural pastoral cooperative medical system was fully implemented and established in the whole banner. At the same time, we will further improve the medical assistance system in rural pastoral areas, reduce the economic burden of farmers and herdsmen due to diseases, improve the health of farmers and herdsmen, and promote the coordinated development of economic and social development in rural pastoral areas.
II. Basic Principles and Requirements The new rural pastoral cooperative medical care system is organized, guided and supported by the government. Farmers and herdsmen volunteer to participate, and individual, collective and government fundraising, and the mutual aid and mutual aid system for farmers and herdsmen with major illnesses. To promote the construction of a new rural pastoral cooperative medical system, we must follow the principle of “voluntary, mutual assistance, openness, and service”.
Establishing a new cooperative medical system for rural pastoral areas is a very complicated and arduous task. It is necessary to recognize and grasp the new characteristics of new rural pastoral cooperative medical care. First, we must adhere to the voluntary participation of farmers and herdsmen in the family, respect the wishes of farmers and herdsmen, and not engage in any form of forced orders and hard apportionment; second, on the basis of individual financing of farmers and herdsmen, increase government support, and the flag finance should be implemented as required. The subsidy funds will be allocated in full and on time, and a fundraising mechanism combining individual contributions, collective support and government subsidies will be gradually established to reflect the mutual aid and mutual aid nature. Third, it is necessary to highlight the large-scale medicine for farmers and herdsmen. Fees and hospitalization medical expenses are subsidized to focus on solving the poverty caused by serious diseases caused by farmers and herdsmen; Fourth, we must coordinate with the flag to form a flag-based management system, strengthen supervision and enhance the ability to resist risks; A transparent management and service system empowers farmers and herdsmen to know, participate, and supervise, and improve the openness, fairness, and impartiality of the system. Sixth, we must put the interests of farmers and herdsmen first, and truly benefit the people and the people. Benefit from the satisfactory medical and health services; seventh, the government is responsible for establishing the leading institutions, handling agencies and regulatory agencies, Strong leadership, management and supervision; to establish eight medical aid system to support poor farmers and herdsmen to participate in cooperative medical subsidy and then solve poverty caused by poverty and civil affairs departments. To carry out the new rural pastoral cooperative medical work, we must grasp the above requirements, proceed from the fundamental interests of the majority of farmers and herdsmen, carefully organize, meticulously operate, and solidly promote, laying a good foundation for the healthy development of new rural pastoral cooperative medical care.
Third, the main content organization management
1. Leading institutions. The flag government established the "Balin Zuoqi New Rural Pastoral Area Cooperative Medical Work Management Committee", headed by the head of the flag, and was responsible for formulating the development plan and related policies for the cooperative medical service in the rural pastoral areas of the whole country, guiding and supervising the work of the localities, and coordinating the work in coordination. Major issue. Each Sumu town and street shall establish a corresponding leading agency responsible for the organization, coordination, management and guidance of cooperative medical care in the region. The village will establish a cooperative medical management team.
2, the office. The flag new rural pastoral area cooperative medical work management committee has an office, the office is located in the flag health bureau, specifically responsible for the business management and daily work of cooperative medical care. Sumu Town and the street should also establish a joint management office. Sumu Town and the street joint management office are located in the Sumu Town Health Center, and the Sumu Town Health Center is entrusted to manage the daily business of cooperative medical care. The flag management office is equipped with 8 staff members. Each Sumu Town Health Center is equipped with 2 staff members. The staff of Sumu Town and Street Management Office are adjusted by the flag health bureau in the health system.
3. Working expenses. The flag government arranged corresponding work funds for the development of new rural pastoral cooperative medical work. The salary and work expenses of the staff of the United States and the United States are included in the flag-level budget. The salary subsidies and working expenses of the Sumu Town and the Street Management Office are included in the budget of the flag and may not be extracted from the new rural pastoral cooperative medical fund.
The fund raises a new rural pastoral cooperative medical system to implement a fundraising mechanism that combines individual contributions, collective support and government funding.
1. Individual payment. Farmers and herdsmen pay 10 yuan per person per year. The five-guarantee households and special-poor households in the rural pastoral areas holding the documents participate in the new type of cooperative medical care in the local area. The personal fund-raising part is paid by the civil affairs department from the medical aid fund according to the poverty-stricken households and the five-guarantee households in the rural pastoral areas.
2. Collective support. Conditional rural collective economic organizations should give appropriate support to the local new rural pastoral cooperative medical care system, and part of the collective investment should not be apportioned to farmers and herdsmen. Encourage social groups and individuals to subsidize the new rural pastoral cooperative medical system.
3. Government subsidies. The central government subsidizes 20 yuan per year for farmers and herdsmen who participate in the new rural pastoral cooperative medical care, and the autonomous region, city, and flag finance each subsidize 20 yuan per year. The autonomous region, city, and flag level finances shall arrange subsidy funds in a ratio of 10:5:5. The flag-level finance will increase the investment according to the economic development.
The fund management rural pastoral cooperative medical fund shall be managed and used in accordance with the principle of balance of income and expenditure, balance of payments, and openness, fairness and impartiality. Fund special accounts for storage, the implementation of two lines of special management of revenue and expenditure, must be earmarked for special purposes, can not be misappropriated.
1. Management method. The Rural Pastoral Area Cooperative Medical Fund is managed by the Qiqi Rural Pastoral Area Cooperative Medical Management Committee and its handling agencies. The flag-level comprehensive management is adopted, and the household account is based on the accounting method of Sumu Town. Adopting a unified bidding method, selecting commercial banks with wide network coverage, good reputation, high service quality and providing preferential support conditions as the agent banks of cooperative medical funds, all cooperative medical funds are all paid into the financial special accounts opened by the financial department in the correspondent banks. To achieve "the bank sees the money does not see the account, the agency does not see the money," the real realization of the new cooperative medical fund income and expenditure separation, closed operation.
2. Collection method. The individual contributions of farmers and herdsmen can be collected by the Sumu Town Government and the sub-district office on the premise of voluntary participation and contractual commitments, and special receipts uniformly printed by the financial department will be issued. The support funds for the collective economy shall be collected by the Qihe Management Office and its entrusted agencies. Individual and collective contributions shall be transferred to the financial special account of the Rural Pastoral Area Cooperative Medical Fund in a timely manner. The financial support funds at all levels shall be allocated by the Finance Bureau to the financial special accounts of the Rural Pastoral Area Cooperative Medical Fund according to the actual number of people participating in the new rural pastoral cooperative medical care.
3. Collection period. The next year's fund paid by farmers and herdsmen will be collected by December 20 of the same year. The flag-based management office shall count the number of farmers and herdsmen participating in cooperative medical care before the end of December of that year, and report it to the higher-level finance, health and other relevant departments after approval.
Subsidy principles and methods
1. The principle of subsidy. The Cooperative Medical Fund mainly implements large-scale medical expenses and subsidies, and establishes a major illness fund and a family account. The family account fund is 8 yuan per person, which is used to pay for personal outpatient medical expenses, and the remaining 2 yuan is included in the major disease co-ordination fund for the hospitalization of large-scale cooperative medical farmers and herdsmen and the reimbursement of large medical expenses. Non-hospital medical expenses may not be used for major illness funds.
2. The proportion and amount of subsidies. According to the total amount of funds raised, the Qigong Medical Management Committee reasonably determines the deductible line, capping line and subsidy ratio of the family account of the cooperative medical fund and the large medical expenses subsidy. It is necessary to prevent the subsidy ratio from being too high and overdraft, and it is also impossible to precipitate the fund because the subsidy ratio is too low, which will affect the benefits of farmers and herdsmen. The annual cooperative medical fund balance must not exceed 15% of the total annual fund. It is necessary to establish a 3% cooperative medical risk fund based on my flag. The inpatient medical expenses deductible line is 100 yuan for the Sumu Town Health Center, 200 yuan for the county-level medical institution, and 400 yuan for the medical institution above the flag level. The proportion of reimbursement is 40% to 60% in Sumu Town Health Center and 30% to 50% in flag-level medical institutions. The reimbursement rate of medical institutions above the flag level is 20% to 35%, focusing on solving the economic burden of serious diseases caused by farmers and herdsmen. The maximum cap line is no more than 20,000 yuan. Each Sumu Town and Street Management Office shall guide farmers and herdsmen to use their family accounts reasonably. The balance of the family account can be carried over to the next year, but it will not be paid for the next year.
3. Accounting method. It is necessary to actively explore the simple way of accounting, and timely review and reimburse the medical expenses of the farmers and herdsmen in the flag, Sumu Town, and the village. The compensation for hospitalization medical expenses shall provide convenience for farmers and herdsmen. The hospitalization expenses for farmers and herdsmen who participate in cooperative medical care shall be paid by the person first, and the reimbursement shall be made at the time of discharge from the designated medical institution, and the designated medical institution shall settle with the joint management office. When the farmers and herdsmen who transferred to the hospital for medical treatment reimbursed medical expenses, they went to the Sumu Town Co-management Office to reimburse them after public notice, and the Sumu Town Co-management Office and the Qihe Management Office settled. The expenses for the designated medical institutions to violate the relevant provisions of the cooperative medical system shall not be reimbursed.
Supervision and management
1. Supervisory agency. The flag committee and the flag government set up the rural pastoral cooperative medical supervision committee composed of the deputy secretary of the flag committee, the flag auditing and supervision department, and the representatives of farmers and herdsmen who participated in the cooperative medical care. They are responsible for the use of the new rural pastoral cooperative medical fund. Management is checked and supervised. Each of the Sumu towns and streets must also establish corresponding institutions to perform the above functions.
2. Supervision measures. The joint management office shall report to the cooperative medical management committee and the cooperative medical work supervision committee regularly the income and expenditure and use of the rural pastoral cooperative medical fund. Each administrative village of Sumu Town and the street shall establish a public medical reimbursement bulletin column, which shall be published on a regular basis. The specific income and expenditure, use of the rural pastoral cooperative medical fund, and the participation of farmers and herdsmen and medical expenses subsidies ensure that farmers and herdsmen participating in cooperative medical care have the right to participate, know and supervise, and ensure that the new rural pastoral cooperative medical system is open and fair. just. To establish a reporting and complaints system, the handling agency should announce the complaint telephone number of the cooperative medical service agency to the public and respond to the complaint within 20 working days. The audit department shall regularly audit the income and expenditure and management of the rural pastoral cooperative medical fund and publicize the audit results.
Medical service management
1. Service organization management. In accordance with the principle of high quality service and low price, the Banner Rural Pastoral Area Cooperative Medical Management Committee should select a new type of rural pastoral cooperative medical service in rural pastoral health institutions. In principle, the designated institutions are mainly non-profit medical and health institutions. After passing the examination, it will be issued to the “New Rural Pastoral Area Cooperative Medical Center Medical Certificate” and announced to the public. Farmers and herdsmen who participate in cooperative medical care can choose medical institutions to choose medical institutions for medical treatment within the scope of the whole banner. The new rural pastoral cooperative medical service agency signs a contract with the designated medical institution to clarify the rights, responsibilities and obligations of both parties. The designated medical institutions must ensure the quality of services and improve service efficiency by establishing various management systems. It is necessary to strengthen the supervision and management of the service quality of designated medical institutions, prevent excessive medical treatment, open large prescriptions, conduct more inspections, and increase the phenomenon of overcharging. Irregular use of drugs, abuse of hormones and antibiotics by rural doctors must be strictly managed. The new rural pastoral cooperative medical care designated medical institutions implement dynamic management, and medical institutions that violate the regulations can cancel their qualifications for designated medical institutions.
2. Referral system. The Flag Cooperative Medical Management Committee should establish a scientific referral and two-way referral system, rationally divert patients, reduce the cost of medical services, and take effective measures to strictly control medical expenses due to disease treatment.
3. Basic medication system. Medical institutions at all levels shall use drugs in accordance with the Catalogue of Essential Medicines for Cooperative Medical Treatment in New Rural Pastoral Areas of Inner Mongolia Autonomous Region.
IV. Implementation Steps The Cooperative Medical Work Management Committee shall actively carry out all relevant work in accordance with this plan, including sound institutions, baseline surveys, visits and study, formulation and adjustment of implementation plans, training of personnel, promotion and mobilization, fund raising, and improvement of the system. To ensure the official start of operation on January 1, XX.
Propaganda and guidance should be targeted, concrete, vivid and vivid through typical cases, and the new cooperative medical care participation methods, participants' rights and obligations, and reimbursement and management methods should be publicized to thousands of households, so that the majority of farmers and herdsmen can pass People and things that can be seen and touched, truly understand the significance of establishing a new cooperative medical system for rural pastoral areas, and voluntarily participate in the new rural pastoral cooperative medical care.
The organization and implementation of the flagship management office should strengthen on-site supervision, keep abreast of the implementation of various localities, timely study and solve problems in the implementation process, and ensure the smooth progress of cooperative medical work.
Summarizing the experience The flag-based management office should continue to seriously summarize the work situation of cooperative medical care in the new rural pastoral areas. It is necessary to conduct a serious analysis of the medical and herdsmen's medical treatment, expense reimbursement, and service status of designated medical institutions, and adjust the work plan in a timely manner every year. The Qigong Medical Management Committee shall organize work meetings according to the work situation of each locality, summarize and exchange work experience, propose solutions to existing problems, study and deploy work, and promote the smooth implementation of new rural pastoral cooperative medical care.
V. Safeguard measures Strengthen leadership and implement responsibility The new rural pastoral cooperative medical work is led by the flag government and the department is responsible for the division of labor. The health department should effectively play a functional role, do a good job in investigation and research, strengthen supervision and management of designated medical institutions, strengthen the review, system construction and inspection and acceptance of new rural pastoral cooperative medical work funds; the financial department should timely allocate funds to strengthen fund management; The department should find out the base of poor families and strictly control it to ensure that poverty relief funds are used for the people most in need of assistance; the audit department should regularly audit and check the financial income and expenditure of the fund to ensure the safe and rational use of the fund; The departments of agriculture, animal husbandry, drug supervision, and poverty alleviation should incorporate the new rural pastoral cooperative medical care into the economic and social development plan and the work content of the department; the correspondent banks should provide support conditions, improve the fund management network system, and ensure full operation. The people's governments and sub-district offices of each Sumu Town shall clarify their responsibilities in four aspects: strengthening leadership, clear tasks, financial guarantees, and management supervision, and ensuring the smooth implementation of the pilot project for cooperative medical care in the new rural pastoral areas.
Establishing a medical assistance fund for poor families and a medical assistance system The medical assistance fund for poor families in rural pastoral areas will be co-ordinated, accounted and managed on a flag-by-flag basis. The main targets of the rescue are the “five guarantees” in the rural pastoral areas, the decentralized support for the five-guarantee elderly and the centralized support for the five-guarantee households, the rural pastoral minors or the rural pastoral areas. The specific measures for assistance shall be determined by the Qihu Civil Affairs Bureau in accordance with the Detailed Rules for the Implementation of Medical Assistance in Rural Pastoral Areas of Inner Mongolia Autonomous Region.
Efforts to improve the health service conditions in rural pastoral areas and improve the quality of service should combine the new rural pastoral cooperative medical work with the rural pastoral health system reform, and vigorously promote the construction of the health service network of the three-level rural pastoral areas in Qiqi, Sumu and Yuchao villages. Improve infrastructure conditions, establish and improve health service systems in rural pastoral areas, and improve the quality of medical and health teams in rural pastoral areas and comprehensive service capabilities. Increase investment in health workers' salaries and work expenses, focus on strengthening the construction of health centers in Sumu Town Center, and improve the infrastructure and equipment conditions of general health centers. We will deepen the reform of the internal operational mechanism of medical institutions in rural pastoral areas, introduce a competitive mechanism, and enhance vitality. Increase urban support for health work in rural pastoral areas. Strengthen the construction of industry style, update concepts, change style, correct service attitude, improve technical level and service quality, and enable limited funds to maximize benefits.
Strengthening training and improving the construction of new rural pastoral cooperative medical management team The health administrative department should conduct general training around the relevant policies of rural pastoral health and the design, compensation, management, supervision, evaluation and adjustment of new rural pastoral cooperative medical care. Further improve management level, standardize operation and ensure quality.
Strengthening the information management The flagship management office shall, in accordance with the requirements of the “Basic Norms of the New Rural Cooperative Medical Information System” issued by the Ministry of Health, generally use the unified management software of the Ministry of Health in Qiqi and Sumu Towns to standardize information management. In accordance with the "Inner Mongolia Autonomous Region New Rural Pastoral Area Cooperative Medical Information System Construction Project Plan" jointly issued by the Health Department and the Department of Finance of the Autonomous Region, the information management will be carried out to realize the information management of the new rural pastoral cooperative medical care.
I. Guiding ideology, guidelines, objectives, mission guiding ideology, and guidelines for doing a good job in the cooperative work of the new rural pastoral areas must be guided by the important thinking of the "Three Represents" and the spirit of the Sixth Plenary Session of the 16th CPC Central Committee to strengthen leadership and increase investment. Prepare carefully; proceed from the actual situation, adapt to local conditions, respect the wishes of farmers and herdsmen; coordinate urban and rural development, promote social equity, solve the problem of lack of medical care and medical treatment in rural pastoral areas; increase efforts to accelerate the promotion of new rural pastoral cooperative medical care system The pace of construction; the interests of farmers and herdsmen must be put first, improve services, improve quality, and ensure the benefits of farmers and herdsmen.
Objectives and tasks Actively research and explore new rural pastoral cooperative medical policy measures, operational mechanisms, service systems and supervision methods that adapt to the level of social and economic development of our flag, the economic endurance of farmers and herdsmen, and the supply and demand of medical services. In XX, in accordance with the requirements of the people's government of the autonomous region, the new rural pastoral cooperative medical system was fully implemented and established in the whole banner. At the same time, we will further improve the medical assistance system in rural pastoral areas, reduce the economic burden of farmers and herdsmen due to diseases, improve the health of farmers and herdsmen, and promote the coordinated development of economic and social development in rural pastoral areas.
II. Basic Principles and Requirements The new rural pastoral cooperative medical care system is organized, guided and supported by the government. Farmers and herdsmen volunteer to participate, and individual, collective and government fundraising, and the mutual aid and mutual aid system for farmers and herdsmen with major illnesses. To promote the construction of a new rural pastoral cooperative medical system, we must follow the principle of “voluntary, mutual assistance, openness, and service”.
Establishing a new cooperative medical system for rural pastoral areas is a very complicated and arduous task. It is necessary to recognize and grasp the new characteristics of new rural pastoral cooperative medical care. First, we must adhere to the voluntary participation of farmers and herdsmen in the family, respect the wishes of farmers and herdsmen, and not engage in any form of forced orders and hard apportionment; second, on the basis of individual financing of farmers and herdsmen, increase government support, and the flag finance should be implemented as required. The subsidy funds will be allocated in full and on time, and a fundraising mechanism combining individual contributions, collective support and government subsidies will be gradually established to reflect the mutual aid and mutual aid nature. Third, it is necessary to highlight the large-scale medicine for farmers and herdsmen. Fees and hospitalization medical expenses are subsidized to focus on solving the poverty caused by serious diseases caused by farmers and herdsmen; Fourth, we must coordinate with the flag to form a flag-based management system, strengthen supervision and enhance the ability to resist risks; A transparent management and service system empowers farmers and herdsmen to know, participate, and supervise, and improve the openness, fairness, and impartiality of the system. Sixth, we must put the interests of farmers and herdsmen first, and truly benefit the people and the people. Benefit from the satisfactory medical and health services; seventh, the government is responsible for establishing the leading institutions, handling agencies and regulatory agencies, Strong leadership, management and supervision; to establish eight medical aid system to support poor farmers and herdsmen to participate in cooperative medical subsidy and then solve poverty caused by poverty and civil affairs departments. To carry out the new rural pastoral cooperative medical work, we must grasp the above requirements, proceed from the fundamental interests of the majority of farmers and herdsmen, carefully organize, meticulously operate, and solidly promote, laying a good foundation for the healthy development of new rural pastoral cooperative medical care.
Third, the main content organization management
1. Leading institutions. The flag government established the "Balin Zuoqi New Rural Pastoral Area Cooperative Medical Work Management Committee", headed by the head of the flag, and was responsible for formulating the development plan and related policies for the cooperative medical service in the rural pastoral areas of the whole country, guiding and supervising the work of the localities, and coordinating the work in coordination. Major issue. Each Sumu town and street shall establish a corresponding leading agency responsible for the organization, coordination, management and guidance of cooperative medical care in the region. The village will establish a cooperative medical management team.
2, the office. The flag new rural pastoral area cooperative medical work management committee has an office, the office is located in the flag health bureau, specifically responsible for the business management and daily work of cooperative medical care. Sumu Town and the street should also establish a joint management office. Sumu Town and the street joint management office are located in the Sumu Town Health Center, and the Sumu Town Health Center is entrusted to manage the daily business of cooperative medical care. The flag management office is equipped with 8 staff members. Each Sumu Town Health Center is equipped with 2 staff members. The staff of Sumu Town and Street Management Office are adjusted by the flag health bureau in the health system.
3. Working expenses. The flag government arranged corresponding work funds for the development of new rural pastoral cooperative medical work. The salary and work expenses of the staff of the United States and the United States are included in the flag-level budget. The salary subsidies and working expenses of the Sumu Town and the Street Management Office are included in the budget of the flag and may not be extracted from the new rural pastoral cooperative medical fund.
The fund raises a new rural pastoral cooperative medical system to implement a fundraising mechanism that combines individual contributions, collective support and government funding.
1. Individual payment. Farmers and herdsmen pay 10 yuan per person per year. The five-guarantee households and special-poor households in the rural pastoral areas holding the documents participate in the new type of cooperative medical care in the local area. The personal fund-raising part is paid by the civil affairs department from the medical aid fund according to the poverty-stricken households and the five-guarantee households in the rural pastoral areas.
2. Collective support. Conditional rural collective economic organizations should give appropriate support to the local new rural pastoral cooperative medical care system, and part of the collective investment should not be apportioned to farmers and herdsmen. Encourage social groups and individuals to subsidize the new rural pastoral cooperative medical system.
3. Government subsidies. The central government subsidizes 20 yuan per year for farmers and herdsmen who participate in the new rural pastoral cooperative medical care, and the autonomous region, city, and flag finance each subsidize 20 yuan per year. The autonomous region, city, and flag level finances shall arrange subsidy funds in a ratio of 10:5:5. The flag-level finance will increase the investment according to the economic development.
The fund management rural pastoral cooperative medical fund shall be managed and used in accordance with the principle of balance of income and expenditure, balance of payments, and openness, fairness and impartiality. Fund special accounts for storage, the implementation of two lines of special management of revenue and expenditure, must be earmarked for special purposes, can not be misappropriated.
1. Management method. The Rural Pastoral Area Cooperative Medical Fund is managed by the Qiqi Rural Pastoral Area Cooperative Medical Management Committee and its handling agencies. The flag-level comprehensive management is adopted, and the household account is based on the accounting method of Sumu Town. Adopting a unified bidding method, selecting commercial banks with wide network coverage, good reputation, high service quality and providing preferential support conditions as the agent banks of cooperative medical funds, all cooperative medical funds are all paid into the financial special accounts opened by the financial department in the correspondent banks. To achieve "the bank sees the money does not see the account, the agency does not see the money," the real realization of the new cooperative medical fund income and expenditure separation, closed operation.
2. Collection method. The individual contributions of farmers and herdsmen can be collected by the Sumu Town Government and the sub-district office on the premise of voluntary participation and contractual commitments, and special receipts uniformly printed by the financial department will be issued. The support funds for the collective economy shall be collected by the Qihe Management Office and its entrusted agencies. Individual and collective contributions shall be transferred to the financial special account of the Rural Pastoral Area Cooperative Medical Fund in a timely manner. The financial support funds at all levels shall be allocated by the Finance Bureau to the financial special accounts of the Rural Pastoral Area Cooperative Medical Fund according to the actual number of people participating in the new rural pastoral cooperative medical care.
3. Collection period. The next year's fund paid by farmers and herdsmen will be collected by December 20 of the same year. The flag-based management office shall count the number of farmers and herdsmen participating in cooperative medical care before the end of December of that year, and report it to the higher-level finance, health and other relevant departments after approval.
Subsidy principles and methods
1. The principle of subsidy. The Cooperative Medical Fund mainly implements large-scale medical expenses and subsidies, and establishes a major illness fund and a family account. The family account fund is 8 yuan per person, which is used to pay for personal outpatient medical expenses, and the remaining 2 yuan is included in the major disease co-ordination fund for the hospitalization of large-scale cooperative medical farmers and herdsmen and the reimbursement of large medical expenses. Non-hospital medical expenses may not be used for major illness funds.
2. The proportion and amount of subsidies. According to the total amount of funds raised, the Qigong Medical Management Committee reasonably determines the deductible line, capping line and subsidy ratio of the family account of the cooperative medical fund and the large medical expenses subsidy. It is necessary to prevent the subsidy ratio from being too high and overdraft, and it is also impossible to precipitate the fund because the subsidy ratio is too low, which will affect the benefits of farmers and herdsmen. The annual cooperative medical fund balance must not exceed 15% of the total annual fund. It is necessary to establish a 3% cooperative medical risk fund based on my flag. The inpatient medical expenses deductible line is 100 yuan for the Sumu Town Health Center, 200 yuan for the county-level medical institution, and 400 yuan for the medical institution above the flag level. The proportion of reimbursement is 40% to 60% in Sumu Town Health Center and 30% to 50% in flag-level medical institutions. The reimbursement rate of medical institutions above the flag level is 20% to 35%, focusing on solving the economic burden of serious diseases caused by farmers and herdsmen. The maximum cap line is no more than 20,000 yuan. Each Sumu Town and Street Management Office shall guide farmers and herdsmen to use their family accounts reasonably. The balance of the family account can be carried over to the next year, but it will not be paid for the next year.
3. Accounting method. It is necessary to actively explore the simple way of accounting, and timely review and reimburse the medical expenses of the farmers and herdsmen in the flag, Sumu Town, and the village. The compensation for hospitalization medical expenses shall provide convenience for farmers and herdsmen. The hospitalization expenses for farmers and herdsmen who participate in cooperative medical care shall be paid by the person first, and the reimbursement shall be made at the time of discharge from the designated medical institution, and the designated medical institution shall settle with the joint management office. When the farmers and herdsmen who transferred to the hospital for medical treatment reimbursed medical expenses, they went to the Sumu Town Co-management Office to reimburse them after public notice, and the Sumu Town Co-management Office and the Qihe Management Office settled. The expenses for the designated medical institutions to violate the relevant provisions of the cooperative medical system shall not be reimbursed.
Supervision and management
1. Supervisory agency. The flag committee and the flag government set up the rural pastoral cooperative medical supervision committee composed of the deputy secretary of the flag committee, the flag auditing and supervision department, and the representatives of farmers and herdsmen who participated in the cooperative medical care. They are responsible for the use of the new rural pastoral cooperative medical fund. Management is checked and supervised. Each of the Sumu towns and streets must also establish corresponding institutions to perform the above functions.
2. Supervision measures. The joint management office shall report to the cooperative medical management committee and the cooperative medical work supervision committee regularly the income and expenditure and use of the rural pastoral cooperative medical fund. Each administrative village of Sumu Town and the street shall establish a public medical reimbursement bulletin column, which shall be published on a regular basis. The specific income and expenditure, use of the rural pastoral cooperative medical fund, and the participation of farmers and herdsmen and medical expenses subsidies ensure that farmers and herdsmen participating in cooperative medical care have the right to participate, know and supervise, and ensure that the new rural pastoral cooperative medical system is open and fair. just. To establish a reporting and complaints system, the handling agency should announce the complaint telephone number of the cooperative medical service agency to the public and respond to the complaint within 20 working days. The audit department shall regularly audit the income and expenditure and management of the rural pastoral cooperative medical fund and publicize the audit results.
Medical service management
1. Service organization management. In accordance with the principle of high quality service and low price, the Banner Rural Pastoral Area Cooperative Medical Management Committee should select a new type of rural pastoral cooperative medical service in rural pastoral health institutions. In principle, the designated institutions are mainly non-profit medical and health institutions. After passing the examination, it will be issued to the “New Rural Pastoral Area Cooperative Medical Center Medical Certificate” and announced to the public. Farmers and herdsmen who participate in cooperative medical care can choose medical institutions to choose medical institutions for medical treatment within the scope of the whole banner. The new rural pastoral cooperative medical service agency signs a contract with the designated medical institution to clarify the rights, responsibilities and obligations of both parties. The designated medical institutions must ensure the quality of services and improve service efficiency by establishing various management systems. It is necessary to strengthen the supervision and management of the service quality of designated medical institutions, prevent excessive medical treatment, open large prescriptions, conduct more inspections, and increase the phenomenon of overcharging. Irregular use of drugs, abuse of hormones and antibiotics by rural doctors must be strictly managed. The new rural pastoral cooperative medical care designated medical institutions implement dynamic management, and medical institutions that violate the regulations can cancel their qualifications for designated medical institutions.
2. Referral system. The Flag Cooperative Medical Management Committee should establish a scientific referral and two-way referral system, rationally divert patients, reduce the cost of medical services, and take effective measures to strictly control medical expenses due to disease treatment.
3. Basic medication system. Medical institutions at all levels shall use drugs in accordance with the Catalogue of Essential Medicines for Cooperative Medical Treatment in New Rural Pastoral Areas of Inner Mongolia Autonomous Region.
IV. Implementation Steps The Cooperative Medical Work Management Committee shall actively carry out all relevant work in accordance with this plan, including sound institutions, baseline surveys, visits and study, formulation and adjustment of implementation plans, training of personnel, promotion and mobilization, fund raising, and improvement of the system. To ensure the official start of operation on January 1, XX.
Propaganda and guidance should be targeted, concrete, vivid and vivid through typical cases, and the new cooperative medical care participation methods, participants' rights and obligations, and reimbursement and management methods should be publicized to thousands of households, so that the majority of farmers and herdsmen can pass People and things that can be seen and touched, truly understand the significance of establishing a new cooperative medical system for rural pastoral areas, and voluntarily participate in the new rural pastoral cooperative medical care.
The organization and implementation of the flagship management office should strengthen on-site supervision, keep abreast of the implementation of various localities, timely study and solve problems in the implementation process, and ensure the smooth progress of cooperative medical work.
Summarizing the experience The flag-based management office should continue to seriously summarize the work situation of cooperative medical care in the new rural pastoral areas. It is necessary to conduct a serious analysis of the medical and herdsmen's medical treatment, expense reimbursement, and service status of designated medical institutions, and adjust the work plan in a timely manner every year. The Qigong Medical Management Committee shall organize work meetings according to the work situation of each locality, summarize and exchange work experience, propose solutions to existing problems, study and deploy work, and promote the smooth implementation of new rural pastoral cooperative medical care.
V. Safeguard measures Strengthen leadership and implement responsibility The new rural pastoral cooperative medical work is led by the flag government and the department is responsible for the division of labor. The health department should effectively play a functional role, do a good job in investigation and research, strengthen supervision and management of designated medical institutions, strengthen the review, system construction and inspection and acceptance of new rural pastoral cooperative medical work funds; the financial department should timely allocate funds to strengthen fund management; The department should find out the base of poor families and strictly control it to ensure that poverty relief funds are used for the people most in need of assistance; the audit department should regularly audit and check the financial income and expenditure of the fund to ensure the safe and rational use of the fund; The departments of agriculture, animal husbandry, drug supervision, and poverty alleviation should incorporate the new rural pastoral cooperative medical care into the economic and social development plan and the work content of the department; the correspondent banks should provide support conditions, improve the fund management network system, and ensure full operation. The people's governments and sub-district offices of each Sumu Town shall clarify their responsibilities in four aspects: strengthening leadership, clear tasks, financial guarantees, and management supervision, and ensuring the smooth implementation of the pilot project for cooperative medical care in the new rural pastoral areas.
Establishing a medical assistance fund for poor families and a medical assistance system The medical assistance fund for poor families in rural pastoral areas will be co-ordinated, accounted and managed on a flag-by-flag basis. The main targets of the rescue are the “five guarantees” in the rural pastoral areas, the decentralized support for the five-guarantee elderly and the centralized support for the five-guarantee households, the rural pastoral minors or the rural pastoral areas. The specific measures for assistance shall be determined by the Qihu Civil Affairs Bureau in accordance with the Detailed Rules for the Implementation of Medical Assistance in Rural Pastoral Areas of Inner Mongolia Autonomous Region.
Efforts to improve the health service conditions in rural pastoral areas and improve the quality of service should combine the new rural pastoral cooperative medical work with the rural pastoral health system reform, and vigorously promote the construction of the health service network of the three-level rural pastoral areas in Qiqi, Sumu and Yuchao villages. Improve infrastructure conditions, establish and improve health service systems in rural pastoral areas, and improve the quality of medical and health teams in rural pastoral areas and comprehensive service capabilities. Increase investment in health workers' salaries and work expenses, focus on strengthening the construction of health centers in Sumu Town Center, and improve the infrastructure and equipment conditions of general health centers. We will deepen the reform of the internal operational mechanism of medical institutions in rural pastoral areas, introduce a competitive mechanism, and enhance vitality. Increase urban support for health work in rural pastoral areas. Strengthen the construction of industry style, update concepts, change style, correct service attitude, improve technical level and service quality, and enable limited funds to maximize benefits.
Strengthening training and improving the construction of new rural pastoral cooperative medical management team The health administrative department should conduct general training around the relevant policies of rural pastoral health and the design, compensation, management, supervision, evaluation and adjustment of new rural pastoral cooperative medical care. Further improve management level, standardize operation and ensure quality.
Strengthening the information management The flagship management office shall, in accordance with the requirements of the “Basic Norms of the New Rural Cooperative Medical Information System” issued by the Ministry of Health, generally use the unified management software of the Ministry of Health in Qiqi and Sumu Towns to standardize information management. In accordance with the "Inner Mongolia Autonomous Region New Rural Pastoral Area Cooperative Medical Information System Construction Project Plan" jointly issued by the Health Department and the Department of Finance of the Autonomous Region, the information management will be carried out to realize the information management of the new rural pastoral cooperative medical care.
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