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The General Office of the State Council issued the Guiding Opinions on Promoting the Reform of the Medical Security Fund Supervision System.
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Industry News
Time：2020-07-10
The State Council's General Office recently issued the Guiding Opinions on Promoting the Reform of the Medical Insurance Fund Supervision System (hereinafter referred to as the "Opinions"). These Opinions implement the work requirements of the CPC Central Committee and the State Council on strengthening the supervision of medical insurance funds, comprehensively improving the governance capacity of medical insurance, deeply purifying the operating environment of the system, and strictly guarding the safety red line of the funds.
The Opinions point out that medical insurance funds are the "money for seeing a doctor" and "life-saving money" of the people. Since the establishment of the basic medical insurance system, the coverage has continuously expanded, and the level of protection has gradually improved. This has played a positive role in safeguarding the health rights and interests of the people, alleviating poverty caused by illness, and promoting reforms in the medical and health system. However, due to factors such as an imperfect regulatory system and an imperfect incentive and restraint mechanism, the efficiency of medical insurance fund use is not high, and the situation of fund supervision is quite severe.
The Opinions emphasize that we should be guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, fully implement the spirit of the 19th National Congress of the CPC and the second, third, and fourth plenary sessions of the 19th CPC Central Committee, and accelerate the reform of the medical insurance fund supervision system. By 2025, a medical insurance fund supervision system and law enforcement system will be basically established, forming a comprehensive supervision pattern based on the rule of law, credit management, multi-form inspections, big data supervision, combined with Party committee leadership, government supervision, social supervision, industry self-discipline, and individual integrity. This will achieve the legalization, professionalization, standardization, and normalization of medical insurance fund supervision, and will continue to develop and improve in practice.
The Opinions require clarifying supervisory responsibilities. Strengthening Party leadership, continuously improving the leadership system and work mechanism for Party building in medical insurance fund supervision. Strengthening government supervision, giving full play to the leading role of the government in the rule of law construction, standard setting, law enforcement, and information sharing of fund supervision. Promoting industry self-regulation, guiding and supporting medical and health industry organizations to play a better role in promoting industry self-discipline.
The Opinions propose promoting the reform of the supervision system. Establishing and improving supervision and inspection systems, comprehensively establishing intelligent monitoring systems, establishing and improving reporting and reward systems, establishing credit management systems, establishing comprehensive supervision systems, and improving social supervision systems.
The Opinions emphasize improving supporting measures. Strengthening the rule of law and normative guarantee of medical insurance fund supervision, strengthening the capacity guarantee for medical insurance fund supervision and inspection, increasing the punishment of fraudulent insurance behavior, comprehensively promoting related medical insurance system reforms, and coordinating the promotion of medical service system reforms.
The Opinions require that local governments at all levels should fully understand the importance of promoting the reform of the medical insurance fund supervision system, strengthen leadership, unify deployment, and coordinate promotion. Incentive and accountability mechanisms should be established, and the work of combating fraudulent insurance should be included in relevant work assessments. The importance of strengthening the supervision of medical insurance funds should be vigorously publicized, actively responding to social concerns, and striving to create a good atmosphere for reform.
Source: Xinhua News Agency
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