Guizhou Provincial Bureau of Medical Protection Functional Information
Guizhou provincial medical insurance bureau main responsibilities:
The Provincial Medical Insurance Bureau implements the guidelines, policies and decision-making arrangements of the Party Central Committee and the Provincial Party Committee on medical insurance, and adheres to and strengthens the Party's centralized and unified leadership of medical insurance in the course of performing its duties. The main responsibilities are:
(a) to implement national laws and regulations on medical protection, to formulate local laws and regulations, draft regulations, policies, plans and standards for medical insurance, maternity insurance, medical assistance and other medical protection systems, to formulate departmental regulations and to organize their implementation.
(b) Organize the formulation and implementation of supervision and management of medical insurance funds, establish and improve the safety prevention and control mechanism of medical insurance funds, and promote the reform of the payment method of medical insurance funds.
(iii) Organizing the formulation of policies on medical insurance financing and treatment, improving the dynamic adjustment and regional transfer and balance mechanism, integrating urban and rural medical insurance treatment standards, and establishing and improving the treatment adjustment mechanism that is appropriate to the level of financing. It organizes the formulation and implementation of reform plans for the long-term care insurance system.
(d) Organizing the formulation of unified urban and rural medical insurance catalogs and payment standards for medicines, medical consumables, medical service items and medical service facilities, establishing a dynamic adjustment mechanism, formulating rules for negotiating access to medical insurance catalogs and organizing their implementation.
(e) To organize the formulation of policies on the prices of medicines, medical consumables, medical service items and charges for medical service facilities, establish a mechanism for the reasonable determination and dynamic adjustment of the prices of medical services paid for by the medical insurance scheme, promote the establishment of a market-led mechanism for the formation of prices for social medical services, and set up a system for the monitoring of pricing information and the release of information.
(vi) To formulate bidding and purchasing policies for drugs and medical consumables and supervise their implementation, and to guide the construction of bidding and purchasing platforms for drugs and medical consumables.
(vii) To formulate agreements and payment management methods for designated medical institutions and organize the implementation thereof; to establish and improve the medical insurance credit evaluation system and information disclosure system; to supervise and manage medical service behaviors and medical expenses included in the scope of medical insurance; and to investigate and deal with violations of laws and regulations in the field of medical insurance in accordance with the law.
(viii) Responsible for medical insurance management, public service system and information construction. It organizes the formulation and improvement of policies on the management of medical treatment in other places and the settlement of expenses. It establishes and improves the system of transferring and continuing medical insurance relations. It carries out foreign exchanges and cooperation in the field of medical insurance.
(ix) Formulating policies related to the medical insurance treatment of retirees and supervising their implementation.
(j) Combine the responsibilities of the department, do a good job in military-civilian integration, poverty alleviation and development, and other related work; increase investment in science and technology, improve scientific and technological innovation capacity, and provide protection for the promotion of innovation-driven development; be responsible for the work of production safety and fire safety in this department and in the field of the industry; do a good job in the development of the application of big data and the management of government data resources related to the work of the department, and promote the standardization of the management of data for the departmental government affairs, sharing and opening up in accordance with the law.
(XI) to complete the provincial party committee, the provincial government and the National Health Security Bureau assigned other tasks.
(XII) adjustment of duties. The responsibilities of the Provincial Department of Human Resources and Social Security and its subordinate units for basic medical insurance for urban workers and urban residents and maternity insurance, the responsibilities of the former Provincial Health and Family Planning Commission for new rural cooperative medical care, the responsibilities of the Provincial Development and Reform Commission for the management of prices of medicines and medical services, and the responsibilities of the Provincial Department of Civil Affairs for medical assistance are transferred to the Provincial Bureau of Medical Insurance.
(M) and the provincial health commission of the division of responsibilities. The Provincial Health Commission, the Provincial Health Insurance Bureau and other departments in the medical, health insurance, medicine and other aspects of the strengthening of the system, policy convergence, the establishment of communication and consultation mechanism, synergistic promotion of reforms, improve the efficiency of the use of medical resources and the level of medical protection.
(xiv) Functional transformation. Improve the unified basic medical insurance system for urban and rural residents and the major disease insurance system, establish and improve a comprehensive multi-level medical insurance system covering all people in the province and coordinated between urban and rural areas, continuously improve the level of medical insurance, ensure the rational use of medical insurance funds, ensure safety and control, and push forward the reform of the “three-medicine linkage” among medical care, medical insurance and medicine, so as to better safeguard the medical care needs of the people throughout the province and reduce the burden of medical costs. medical needs and reduce the burden of medical costs.
