Chengdu: Cancel the fee of threshold and submit an expense account Wipe out proportion increase by 2
Author: Why it will be the intersection of poem and loud quick hospital Li, male genital of Huang Xu, " It is asked that a bed is difficult " ? Why does rate rise in hospital? The deputy to the National People's Congress and investigation of member of the CPPCC National Committee find, one of the reasons is to implement serious disease and help each other dangerously on April 1 last year, cause the small disease to crowd the large hospital, even " maliciously in hospital " The phenomenon takes place. This newspaper reported that has caused the municipal medical insurance office to pay close attention to, yesterday, the municipal medical insurance office was solicited the opinion extensively, after surveying and studying conscientiously, help each other and make adjustment to serious disease by inches, cancel the fee of threshold and submit an expense account, increase and submit an expense account the proportion. Municipal the intersection of medical insurance and HongGao Xu, Deputy Bureau Director of office, say adjust, as to need to wipe out competence, drop patient that in hospital really. How to change From May 1 this year to May 1, 2013 160 yuan - threshold fee of 800 yuan can't submit an expense account " fee of threshold " Wipe out, wipe out proportion, raise two percentage point no longer, adjust, improve serious disease, help each other dangerous policy this time, the main content is that two changes and two increase newly. Two changes: Municipal the intersection of medical insurance and HongGao Xu, Deputy Bureau Director of office, say two change, effect an insurance urban worker and urban and rural residents mainly serious disease of personnel help each other by inches wiping out the proportion, raising by two percentage points, turn from 75% into 77%; But the threshold fee no longer includes in paying the range, mean " fee of threshold " of 800 yuan of the hospital of the first, second and third in Chengdu , two first hospitals of threshold fee of 400 yuan, 200 yuan of first class hospital and 160 yuan of community's hospital " The fee of threshold " ,To May 1, 2013, all can't submit an expense account from May 1 this year. In the previous year, these " fee of threshold " Can wipe out 75%. Two are increased newly: Basic medical insurance implement, close standard that way stipulates, carry out by norm according to number; Secondly, one, naturally in the year, to relieve, work behind the relation with unit, continue participating in urban worker's basic medical insurance of this city individual effect an insurance person by way of conducting in hospital, continue serious disease and help each other while continuing basic medical insurance relation in 4 months dangerously voluntarily, should fill, take to pay the medical treatment of serious disease and help each other and supplement the insurance premium current year at one time, dangerous treatment of helping each other that after paying arrears to enjoy serious disease continuously. The calculation formula that at one time pays the expenses is: 80% of average monthly income of worker in Chengdu were the base figure of paying the fees the above one, paying the standard of paying the fees of moon that the rate confirms of 1%, is multiplied by in current year and counted in the remaining moon. The authority understands municipal medical insurance office Deputy Bureau Director Xu HongGao: Need patient in hospital wipe out competence, will drop reporter, evening paper of Chengdu, help each other by inches adjusting, interviewing municipal the intersection of medical insurance and Xu HongGao, Deputy Bureau Director of office, on serious disease really. Xu HongGao says, " it is asked that the sick bed is difficult " in the large hospital where the evening paper of Chengdu reports Very objective, the reason is analyzed to choose the behavior to produce the function of very good public opinion in hospital to medical behavior of the norm and patient correctly in place, adjustment of promoting serious disease to help each other by inches. Reporter: Does the policy adjust the standard of submitting an expense account of reducing the patient? Xu HongGao: From May 1, the medical treatment of serious disease helps each other and supplements the insurance to cancel and submit an expense account to the fee of threshold, but increased the proportion of submitting an expense account, the competence of submitting an expense account in really needing the patient in hospital will not drop. Give an example: If has cost 200,000 yuan in hospital alone, 120,000 yuan among them is expenses that basic medical insurance can submit an expense account, the namely usually said one " Can submit an expense account partly " ,Remaining 80,000 yuan is " Some at one's own expense " ,"It is not 80,000 parts at one's own expense that can all submit an expense account according to 77%. " " some at one's own expense " Divided into 3 kinds again - -All at one's own expense, the needle is in charge of,etc. the apparatus; Get up in one pair of lines, namely " fee of threshold " ; Medicines,etc. submitting an expense account in certain proportion. "That include the category in 77% and submit an expense account is that ' the medicines submitting an expense account in certain proportion are waited for ' this time. " Compare: It is 20,000 yuan, before fee of 800 yuan of threshold is adjusted to suppose that all at one's own expense: [The intersection of 200,000-120,000-2 Wan ] and * 75% =After 45,000 yuan is adjusted: [The intersection of 200,000-120,000-2 ten thousand - 800 ] and * 77% =45,600 yuan still submit an expense account more after changing. Reporter: Where to fine? Xu HongGao: Unit or individual defrauded of expenditure of Medical Benefits Funds, should be not merely ordered to return, will be also subjected to and will defraud of the penalty of more than 1 but less than 3 times amount of money. The fixed medical organization adopts empty means of writing the expenses, exchanging the medicines or project of making a diagnosis, forging the certificate or evidence etc. to defraud of basic Medical Benefits Funds etc. behaviorally, recover its expenses that are obtained and order to rectify and improve in accordance with the law, and violate the penalty of 1 to 3 times of the amount of money. Of a serious nature, cancel its fixed qualification of medical organization, can't award its structural qualification of fixed medical treatment in 5 years. The hospital replies The turnover rate of the sick bed raises the large hospital have " Increase the bed " Plan serious disease and help each other and cancel the fee of threshold and submit an expense account by inches, can prevent being in hospital maliciously to a certain extent. The hospital and Ministry of Health are in relieving the sick bed in shortly, what kind of measure is taken? Yesterday, the intersection of Chengdu and the intersection of evening paper and the intersection of mark and way, soldier of reporter, hospital situation and berth count and empty bed count, go on, visit in hospital to some large hospital and community. The investigation finds, " it is asked that a bed is difficult " in the large hospital ,Community most hospital can meet patient, in hospital need, have will certainly " the empty bed is counted " . Provincial hospital: It is prevented that the special messenger supervises " The entering by the back door " It is reported, there are more than 2000 berths in though the provincial hospital, situation that it is tense to be admitted to hospital exists, breathe and heart, even more in department in common disease in person who digest " It is asked that a bed is difficult " . For this reason, this institute has issued <
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