[Source: Gangcha County People's Government_Picture News] In order to implement the deployment requirements of the provincial and state medical insurance departments "on the supervision of medical insurance funds in 2022", the county medical insurance bureau has carefully organiz

[Source: Gangcha County People's Government_Picture News]

In order to implement the deployment requirements of the provincial and state medical insurance departments "on the supervision of medical insurance funds in 2022", the county medical insurance bureau has benchmarked the medical insurance fund supervision task list , conscientiously organize and implement the supervision and management of medical insurance funds, strengthen the supervision of medical insurance funds, and build the "three major starting points" of medical insurance supervision in the county by deepening the construction of internal control of the medical insurance system, establishing a medical insurance credit system, and improving the medical insurance supervision mechanism. Create a good atmosphere within the scope where the whole society pays attention to and consciously safeguards the safety of medical insurance funds.

provides strong internal control training to improve quality and efficiency. Taking the "Medical Insurance Fund Supervision Publicity Month" as an opportunity, the Medical Insurance Bureau convened the heads of 18 designated medical institutions and medical insurance fund managers in the county to participate in a centralized training session, and invited Huate Lawyer from Qinghai Guanruo Law Firm to provide legal services for the county's medical insurance system. Cadres and employees explained in detail the "Regulations on the Supervision and Management of the Use of Medical Security Funds" (hereinafter referred to as the "Regulations"), guiding business personnel in the county's medical insurance system to enhance their awareness of learning, understanding, and abiding by the law, and to consciously abide by and implement the concepts of the "Regulations" Transformed into the heart and externalized into actions. We will improve the self-disciplined medical insurance management system, strictly regulate the prices of medicines and medical devices, and guide designated medical institutions to consciously benchmark and operate in compliance with the law.

has strong credibility and commitment, is standardized and serves the people. We will resolutely implement the service concept of "medical insurance to benefit the people", vigorously support designated medical institutions to provide standardized medical insurance services to the insured people, carry out integrity education for industry practitioners, and enhance the awareness of medical insurance integrity. Organize designated medical institutions in the county to sign the "Letter of Commitment to Maintain the Security of Medical Security Funds", and encourage the heads of each designated medical institution to take the initiative to post the letter of commitment signed by their unit in a conspicuous place in the unit, supervise the fraud and defrauding behaviors around them, and consciously Accept social supervision and have the courage to take responsibility for preventing fraud and insurance fraud.

is responsible and supervises with care and affection. Continue to promote the construction of social supervision and incentive mechanisms and strive to achieve positive interaction between government supervision, social supervision and public opinion supervision. Actively carry out publicity and education. Promote relevant laws and regulations on medical insurance fund supervision through online + offline "dual mode", and use the WeChat public platform of Gangcha County Medical Security Bureau to launch a short legal popularization video to guide the public to effectively identify fraud and insurance fraud; with the help of the "Ten Advances" activity, we have The insured people have face-to-face communication and answer questions on-site about the congestion and pain points encountered in insurance, reimbursement and medical treatment; by distributing the "Medical Insurance Policy Booklet" and "Combating Fraud and Insurance Fraud Promotion Booklet", the insured people are familiar with Relevant policies such as medical insurance payment, medical insurance benefits, outpatient chronic disease declaration, and crackdown on insurance fraud will "move" the medical insurance policy to the doorsteps of farmers and herdsmen, open up the "last mile" of serving the people, and open channels for complaints and reports. A special hotline for medical insurance complaints and reports has been opened. Through the 12345 government service information platform, the "Into the Cangcheng Gangcha" WeChat public platform and other channels, the methods of complaints and reports are disclosed, and the work processes and mechanisms such as acceptance, inspection, processing, and feedback are standardized to ensure the safety of whistleblowers. Information security, promote the active participation of all parties in society in supervision; focus on exposing typical cases. Adhere to the principles of compliance with laws and regulations, seeking truth from facts, fairness and openness, and "exposing everything that should be exposed", increase the public exposure of typical cases of fraud and insurance fraud by various regulatory objects such as "two designated" institutions and insured people, and strengthen the compliance of all designated medical institutions. Awareness of law-abiding and improving people’s ability to identify fraud and insurance fraud.

Written and videographed by: Zhou Zhihua Reviewed by: Dege Zhuoma

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