Qiannan Prefecture Medical Insurance Bureau

(1) Implement the national medical insurance laws, regulations, rules, and regulations, and formulate the medical insurance, maternity insurance, medical assistance, and other medical security systems, policies, plans, and standards for the whole state and organize their implementation.

(II) Supervise and manage the medical security funds throughout the state, and implement the medical security funds at the state level. Establish and improve the safety control mechanism for medical security funds, and promote the reform of the payment methods for medical security funds.

(3) Organize the formulation of the financing and benefit policies for medical security throughout the state, improve the dynamic adjustment and regional adjustment balance mechanism, coordinate the urban and rural medical security benefit standards, and establish and improve the benefit adjustment mechanism adapted to the financing level. Improve the major illness insurance, high-cost medical insurance, supplementary medical insurance and medical assistance system, and promote the reform of the long-term care insurance system.

(iv) Organize the formulation and implementation of the medical insurance catalog and payment standards for urban and rural areas, including drugs, medical consumables, medical service items, and medical service facilities.

(5) Organize the formulation and implementation of policies on drug, medical consumables price and medical service items, medical service facilities charging, etc. in the whole state, establish a reasonable determination and dynamic adjustment mechanism for the price of medical services paid by medical insurance, promote the establishment of a market-oriented mechanism for the formation of social medical service prices, and establish a price information monitoring and release system.

(6) Formulate centralized procurement policies for pharmaceuticals and medical consumables throughout the state and supervise their implementation, and guide the construction of centralized procurement platforms for pharmaceuticals and medical consumables.

(Seven) Formulate the agreement and payment management measures for designated medical and pharmaceutical institutions in the whole state and organize their implementation, establish and improve the medical security credit evaluation system and information disclosure system, supervise and manage the medical service behavior and medical expenses included in the medical security scope, and investigate and deal with illegal and irregular acts in the medical security field in accordance with the law.

(8) Responsible for the management of medical security in the whole state, the public service system and the construction of information technology. Organize the formulation and improvement of policies for the management of inter-city medical treatment and the settlement of expenses, and establish and improve the transfer and continuation system of medical security relations.

(9) Formulate relevant policies on medical security benefits for retired cadres and other specific personnel and supervise their implementation.

(10) In combination with the responsibilities of the department, do a good job in military-civilian integration, poverty alleviation and other related work; increase scientific and technological investment, improve the ability of scientific and technological innovation, and provide protection for promoting innovation-driven development; be responsible for the safety production and fire safety work of the department and the industry field; in accordance with the regulations, do a good job in the development and application of big data and the management of government data resources, and promote the standard management, sharing and opening of departmental government data in accordance with the law.

(xi) Complete other tasks assigned by the provincial party committee, provincial government, and the provincial medical insurance bureau.

(12) Adjustment of responsibilities. The responsibilities of the state human resources and social security bureau and its subordinate public institutions for urban workers and urban residents' basic medical insurance and maternity insurance, the responsibilities of the state health and family planning commission for new rural cooperative medical system, the responsibilities of the state development and reform commission for drug and medical service price management, and the responsibilities of the state civil affairs bureau for medical assistance, etc., are transferred to the state medical insurance bureau.

(13) Division of responsibilities. Responsibilities related to the State Health and Family Planning Commission: The State Health and Family Planning Commission, the State Medical Insurance Bureau, and other departments will strengthen the coordination of systems and policies in the areas of medical care, medical insurance, and pharmaceuticals, establish a communication and consultation mechanism, coordinate the reform, and improve the efficiency of the use of medical resources and the level of medical security.

(14) Functional transformation. Improve the unified urban employee medical insurance system and the high-cost medical insurance system throughout the state, the basic medical insurance system for urban and rural residents, and the urban employee maternity insurance system, the serious illness insurance system, and the urban and rural medical assistance system. Establish and improve a multi-level medical security system covering all citizens and coordinating urban and rural areas, continuously improve the level of medical security, ensure the rational use and safe control of medical insurance funds, promote the reform of medical, medical insurance, and medical treatment "three medical linkages" in accordance with the division of responsibilities, and better protect the medical needs of the people and reduce the burden of medical expenses.