Article 1 In order to strengthen the management of free medical care and further improve and perfect the management system of free medical care, these measures are formulated in accordance with the Instructions of the former Central People's Government on Preventing the Free Medical Care of State Staff of People's Governments at All Levels, Political Parties, Organizations and Their Affiliated Institutions in recent years and the relevant provisions of the state, and in light of the new situation.
Article 2 The socialized medical care system is a social security system implemented by the state to protect the health of state functionaries. The state provides free medical prevention to those who enjoy free medical prevention within the scope stipulated by the system through the medical and health departments.
Article 3 The implementation of socialized medicine system shall follow the principles of actively preventing diseases, guaranteeing basic medical care and overcoming waste, and shall be managed and supervised by socialized medicine management departments at all levels.
Article 4 Medical institutions undertaking the task of free medical treatment should adhere to the purpose of serving the people wholeheartedly, carry forward the revolutionary humanitarian spirit of saving lives, conscientiously implement the policy of putting prevention first, actively do a good job in disease prevention, adhere to medical principles, treat diseases, use drugs rationally, check rationally and charge reasonably to ensure the correct implementation of the free medical treatment system.
Article 5 Individuals enjoying free medical care and their subordinate units have the obligation to abide by the relevant rules and regulations formulated by the administrative departments of free medical care at all levels. We should earnestly strengthen the ideological education of those who enjoy it, and correct and resist unhealthy trends. Leading cadres at all levels should set an example, and should not use their powers to engage in specialization.
Chapter II Scope of Free Medical Care
Article 6 Persons enjoying free medical care:
First of all, the funds of state organs, political parties and people's organizations at all levels are paid by the state budget and are being prepared.
Staff of various societies, associations, research associations and foundations who take care of themselves or implement differential subsidies do not enjoy free medical care.
Two, all levels of culture, education, science, health, sports, economic construction and other institutions from the state budget, staff in the establishment.
Where the implementation of differential budget management (excluding hospitals owned by the whole people) and self-supporting management of public institutions staff and the units listed in the first and second paragraphs of the above temporary workers, seasonal workers, part-time substitute teachers do not enjoy free medical care.
Three, the wages spent in the state budget, belong to the grass-roots industrial and commercial and tax personnel compiled by the state.
Four, the establishment of full-time staff of the All-China Federation of Trade Unions, local trade unions at all levels and industrial trade unions, as well as the establishment of staff organized by the leading organs of trade unions at or above the county level and institutions that implement full budget management.
Temporary workers, seasonal workers and part-time substitute teachers in institutions organized by trade unions, as well as the staff of trade unions and financial institutions that implement balance management and self-supporting management, do not enjoy free medical care.
Five, belong to enjoy free medical care units, approved by the long-term rest due to illness of supernumerary personnel, long-term support and supernumerary personnel to be allocated.
Six, long-term pension in the township second-class disabled revolutionary servicemen and demobilized conscripts, disabled revolutionary servicemen of the Invalides.
Seven, belongs to the retirees who enjoy free medical care units, retired workers who work in the army.
Eight, not according to the retirement measures in the State Council to enjoy free medical care for employees of administrative institutions, after retirement by the civil affairs department issued a pension.
Nine, the state officially approved the establishment of ordinary colleges and universities (excluding military academies) plans to recruit ordinary college students, graduate students (excluding entrusted training, self-funded students, cadres and special students) and students who have been approved to suspend their studies due to illness 1 year, as well as recent college graduates who cannot be assigned to work within 1 year due to illness.
Ten, enjoy free medical research institutions to recruit graduate students.
Eleven, enjoy the contract cadres and workers recruited by publicly funded medical institutions (excluding contract workers who implement labor insurance and welfare planning).
Twelve, the central and the State Council regulations to enjoy free medical care of other personnel.
Chapter III Scope of Public Medical Expenditure
Article 7 The scope of medical expenses at public expense. The following expenses of the personnel who enjoy the medical treatment at public expense can be reimbursed in whole or in part in the medical treatment at public expense, and the specific reimbursement ratio is reasonably determined by all localities.
First, medical expenses (including bed fees, examination fees, medicine fees, treatment fees, surgery fees, etc.). ) for medical personnel who enjoy free medical treatment in designated medical units.
Two, because of the emergency can not go to the designated medical units, in the nearest medical units (state-owned, collective) medical expenses.
Three, on business or holidays to visit relatives, in the local medical units (state-owned, collective) medical expenses.
4. The medical expenses for short-term recuperation or rehabilitation treatment after surgery or hospitalization for critical illness shall be provided free of charge with the consent of the original treatment unit and the approval of the competent department; Medical expenses for non-surgical or non-critical illness convalescence or rehabilitation shall be recommended by designated hospitals, approved by the unit, approved by the competent medical department, and treated at public expense.
Five, because there is no medicine in the original treatment unit, it is necessary to buy (referring to national pharmacies or other medical units) and attach a hospital certificate of drug costs.
Six, according to the provisions of the transfer to foreign medical units (state-owned, collective) treatment of medical expenses.
Seven, family planning surgery medical expenses.
Eight, imported artificial organs installed by the treatment unit due to illness, the cost shall not exceed the highest domestic price.
Nine, organ transplantation due to illness, according to the principle of public medical care, units and individuals * * * with the burden, the cost should be borne by public medical care.
Ten, disability medical expenses.
Eleven, the cost of precious nourishing drugs (including blood products) necessary to rescue critically ill patients or treat public injuries.
Article 8 Scope of self-expense. In addition to the expenses beyond the scope stipulated in Article 7, the patient shall take care of himself. Examples are as follows:
1. All kinds of self-funded drugs, special-shaped packaged drugs and unapproved purchased drugs that are not reimbursed by public medical care.
2. Registration fee, visiting fee, food fee, special nutrition fee, hospitalization escort fee, intensive care unit fee, baby fee, incubator fee, maternal health care fee, bottle opening fee, Chinese medicine decoction fee (including medicine introduction fee), heating fee, air conditioning fee, telephone fee and electric furnace fee; Television, refrigerator, etc. In the ward.
Three, medical consultation fees, medical insurance premiums (refers to the premium charged during medical treatment), high quality and good price (refers to the characteristic outpatient service opened by the hospital) fees, qigong fees (excluding qigong treatment fees).
Four, non-public medical management departments to organize all kinds of medical examination, preventive medication, vaccination, infertility examination and treatment costs.
Five, all kinds of cosmetic, orthopedic, bodybuilding surgery, treatment and disposal, drugs and other expenses, as well as all the expenses of using orthopedic and bodybuilding equipment.
Six, medical expenses, first aid, consultation fees and consultation transportation.
Seven, the medical expenses of various meetings.
Eight, all kinds of magnetic therapy supplies.
Nine, without the approval of designated medical units or medical institutions at public expense, ask for medical expenses from medical units or doctors.
Ten, without the consent of the public medical management institutions for recuperation, rehabilitation and recuperation of medical expenses.
Eleven, all expenses caused by fighting, fighting, alcoholism, traffic accidents, medical accidents and other injuries.
Twelve, go abroad to visit relatives, study, study and give lectures during the medical expenses.
Thirteen, other expenses that should not be reimbursed in the medical expenses as stipulated by the local medical management department.
Chapter IV Public Medical Management
Article 9 Establish and improve public medical networks, designated public medical hospitals and designated medical institutions. The determination of designated hospitals should be approved by public medical management institutions and enjoyment units. Conditional designated hospitals can set up free medical consultation rooms or designate full-time doctors.
Article 10 The medical office of a unit shall establish health records of employees and actively carry out medical prevention publicity.
Eleventh medical units at all levels should improve the consultation and referral system. For difficult and severe cases, the treatment unit should organize a doctor consultation; If the unconditional treatment in our hospital requires referral, with the approval of the department director, suggestions for referral treatment are put forward. Anyone who needs to be transferred to other places for treatment should hold a summary of the illness of the designated hospital, a referral certificate and a letter of introduction from the unit, and be approved by the competent department of free medical care before referral. Any transfer to other provinces for treatment shall be approved by the provincial (city) medical management department or the health department (bureau), and shall be properly contacted with the transferred hospital in advance. After obtaining the consent, you can transfer to another hospital for treatment.
Twelfth stay in nursing homes and rehabilitation hospitals, should be approved by the original treatment unit, receiving treatment unit, unit, and approved by the competent department of public medical care. Under normal circumstances, the stay in nursing homes or rehabilitation medical institutions shall not exceed 3 months. If the course of treatment needs to be extended, the above-mentioned three-party certificate shall be reported to the competent department of free medical care for approval.
Thirteenth medical units should strengthen drug management. In addition to the canteen, it is not allowed to operate and sell other commodities other than nutrients, nourishing drugs and medicines. Medical personnel and other relevant personnel should strictly implement the provisions of the scope of public medical care, drug limits and drug use norms. Abuse of drugs in violation of regulations, expanding the scope of expenditure and causing consumption, shall be handled in accordance with the relevant provisions of Article 30 of these Measures.
Article 14 Medical personnel should establish a good medical ethics, study medical technology hard, improve service attitude, improve medical quality, adhere to medical principles, consciously correct and resist unhealthy practices, and set an example in observing and implementing the provisions of the free medical care system.
Chapter V Management Institutions and Duties of Public Medical Care
Article 15 Local people's governments at all levels shall set up free medical management committees, which are composed of government leaders and heads of health, finance, organization, personnel, medicine, trade unions and other departments, with the health department as the main body, leading the free medical work at all levels in a unified way, and setting up offices with corresponding full-time management personnel. The responsibilities of public medical management institutions are:
First, implement the national policies and regulations on free medical care and formulate specific implementation measures.
Two, local medical work planning, forecasting, organization and coordination, statistics, research and other management.
Three, enjoy the scope and qualifications of the units and personnel at the same level of free medical care.
Four, responsible for the preparation of the medical expenses budget and the management of the use of funds, and report the final accounts of medical expenses to the competent department.
Five, check and guide the management of public medical care at lower levels.
VI. Publicity and education of public medical policies.
Sixteenth medical units that undertake the task of free medical care should set up free medical management institutions, whose duties are:
First, seriously implement the system and regulations of free medical care.
Two, organize and lead the specific management of hospital free medical care, formulate and implement the measures for the management of hospital free medical care.
Three, supervise and inspect the implementation of the free medical system and regulations in our hospital.
Four, medical expenses package to the hospital or by the hospital escrow, the hospital should regularly submit the implementation of funds to the medical management department.
Seventeenth enjoy medical personnel at public expense units should set up medical management institutions, equipped with full-time or part-time staff. Its duties are:
First, conscientiously implement the local free medical system and regulations, and formulate specific measures for the management of free medical care in this unit.
Two, according to the provisions of the regular report to the medical expenses management department at the same level to enjoy the number of medical expenses and expenses.
Three, medical expenses package to the unit or by the unit escrow, the unit should regularly submit funds to the medical expenses management department.
Four, the management of other matters involving free medical care.
Chapter VI Budget Management of Public Medical Expenses
Article 18 The medical expenses that should be borne by the state according to regulations shall be listed in a separate paragraph in the national budget. The budget is arranged by the financial departments at all levels and allocated to the public medical management institutions for unified management and use through the health department.
Measures for the management of funds of public medical management institutions for medical units, enjoyment units and individuals shall be determined by all localities themselves.
Nineteenth free medical care includes the following items:
First, enjoy the normal medical expenses of medical personnel at public expense.
Two, included in the expenditure of public medical management institutions.
Article 20 The budget quota for publicly-funded medical care shall be determined by all provinces, autonomous regions, municipalities directly under the Central Government and cities under separate state planning according to actual needs and financial resources, and the implementation shall be supervised.
Article 21 If the enjoyment unit moves from Party A to Party B due to the relocation of its office, it shall go through the handover procedures, that is, the competent department of public medical care in Party A shall issue a certificate, and the competent department of public medical care in Party B shall handle the public medical care in accordance with the regulations.
Article 22 Where a central local unit moves across provinces (autonomous regions, municipalities directly under the Central Government and cities with separate plans), the competent department of free medical care in the place of emigration and the central competent department shall issue a certificate, and the competent department of free medical care in the place of emigration shall handle free medical care according to regulations. When the number of immigrants is large, the provincial financial department in the place of emigration and emigration shall report to the Ministry of Finance the transfer payment of free medical care according to the number of immigrants.
Twenty-third enjoy medical personnel transferred to other enjoy units, should go through the formalities for the transfer of medical relations at public expense, that is, the transferred unit shall issue a certificate, and the transferred unit shall handle medical matters at public expense according to regulations.
Twenty-fourth central units in the local public medical care, unified management by the local public medical management institutions, the required funds by the local financial departments to co-ordinate arrangements.
Twenty-fifth college students with wages, their medical expenses are arranged by the original unit in the relevant funds.
Chapter VII Supervision and Inspection of Free Medical Care
Twenty-sixth medical management departments at all levels should establish and improve the supervision and inspection system for units and medical units that enjoy free medical care, and formulate corresponding measures and regulations. Units, individuals and all medical units that enjoy free medical care must strictly abide by the management system and regulations of free medical care and accept the supervision and inspection of the management department of free medical care.
Twenty-seventh free medical supervision and inspection contents include:
First, supervise and inspect the scope of drug purchase and sale and the implementation of medical charges in medical units and drug sales units.
Two, the medical units, medical units to enjoy the scope of medical personnel, the scope of expenditure to implement supervision and inspection.
Three, supervision and inspection of medical units, enjoy the use of medical funds of medical units.
Four, to enjoy the medical expenses reimbursement of medical personnel to carry out supervision and inspection.
Twenty-eighth free medical examination can be organized through self-examination, joint inspection, mutual inspection and spot check. , and equipped with qualified professionals for inspection. The inspection results shall be notified to the relevant units by the competent department of public medical care in a timely manner.
Chapter VIII Assessment, Reward and Punishment of Public Medical Care Work
Twenty-ninth all localities should, according to the actual situation, establish an assessment system for medical care at public expense and formulate regulations on rewards and punishments. The departments in charge of free medical care shall assess the subordinate management departments, enjoyment units and medical units, and the enjoyment units shall assess the enjoyment personnel. The reward and punishment measures of the management departments of free medical care for enjoyment units, individuals and medical units shall be formulated by all localities according to the actual situation.
Thirtieth units and individuals that have made remarkable achievements in strengthening and improving the management of socialized medicine and exemplary implementation of socialized medicine policies and regulations shall be commended or rewarded. For medical units that suffer consumption losses due to lax management and violation of regulations, according to the seriousness of the case, they shall be given informed criticism, the amount of disciplinary violations and bonus income shall be confiscated, and a fine shall be imposed, and all the confiscation and fines shall be turned over to the finance. If the circumstances are bad and violate the criminal law, the legal responsibility shall be investigated.
Those who enjoy free medical care in violation of the provisions of free medical care and cause losses and consumption shall be ordered to compensate for the losses and fined.
Chapter IX Supplementary Provisions
Thirty-first provinces, autonomous regions, municipalities directly under the central government and cities under separate state planning shall formulate detailed rules for implementation according to these measures and report them to the Ministry of Health and the Ministry of Finance for the record.
Article 32 These Measures shall be interpreted by the Ministry of Health and the Ministry of Finance.
Article 33 These Measures shall be implemented as of the date of promulgation. In the past, all provisions that are inconsistent with these measures shall be abolished at the same time.