Opinions on further strengthening the management of chronic diseases

With the steady increase in government subsidy standards and protection levels, the size of the New Rural Cooperative Medical Care (hereinafter referred to as the New Rural Cooperative Medical Care) Fund has continued to expand, the level of medical protection for participating farmers has continued to rise, and the types of chronic illnesses have continued to increase, with compensation ratios and ceiling lines also rising. According to the first half of the chronic disease audit, found that some of the problems jeopardize the safety of the new rural cooperative fund, the healthy and stable development of the new rural cooperative adversely affected. In order to further standardize the management of chronic diseases, and effectively guarantee the safety of the fund, has formulated the following views:

First, strict chronic disease identification and approval management. The township co-management office to strengthen the township declaration of chronic disease information review, the city co-management office of the organization of the relevant expert appraisal group strict identification, there needs to be more than three experts identified before the issuance of “chronic disease outpatient medical certificate.

Second, the implementation of chronic disease-specific medical records and prescription management. Since September 1, 2011, each chronic disease patient is issued one special medical record and prescription free of charge (free of charge for the first time, after using up the old book for a new one, charging the cost of the book). Chronically ill patients should bring “three certificates and one book” (ID card, chronic disease card, cooperative medical card and special medical record book) to the clinic. Chronic disease medical records and prescriptions can only be used by the patients with chronic diseases, and cannot be lent to others. Each township above the designated medical institutions to set up chronic disease outpatient clinics, and have obvious signs.

Third, chronic disease outpatient specialists to implement the filing system (list attached). The chronic disease prescription issued by the physician who has not filed in the municipal cooperative management office is invalid.

Fourth, strict examination of the “three certificates a”. Receiving physician should strictly review the chronic disease ID card, chronic disease card, cooperative medical card and special medical record book, verify the correctness of its condition before diagnosis and treatment, not allowed to ride on the prescribing, not allowed to use the new rural cooperative reimbursement directory of drugs, not allowed to prescribe medicines and inspection, diagnostic and therapeutic items not in line with the condition of the patient, to be registered in the outpatient registration of chronic diseases, medical records and prescriptions.

V. Strictly control the amount of medication for patients with chronic diseases. A prescription for a maximum of one month's medication, each prescription for a maximum of five kinds of drugs, the prescription must be stamped with the hospital chronic disease outpatient special seal, and the physician to sign the full name.

Sixth, strict financial bill management. Each unit should strictly financial management, strictly prohibit malicious false invoices and prescriptions, fraudulent New Agricultural Cooperative Fund; chronic disease prescription and invoice should be consistent, and stamped with a special seal of the fee can be valid.

Seven, chronic disease patients go out for medical treatment to implement the record-keeping system. Indeed, because of the condition of patients with chronic diseases need to Linqing outside the jurisdiction of medical treatment, before going out should be filed to the municipal cooperation management office. Medical expenses not recorded will not be reimbursed.

Eight, chronic disease patients to implement the annual review system. At the end of each year, the townships of the Office of the co-management of the townships of chronic disease patients to carry out an annual review of the condition of whether the recovery, whether the death, whether to participate in the field investigation, and will be reported to the City Office of the co-management of the review situation. The municipal cooperation management office randomly carries out spot checks, and if the review is qualified, the annual review seal will be stamped on the chronic disease outpatient medical card; any chronic disease outpatient medical card that has not been examined will be null and void.

IX. Increase the investigation and handling of violations to ensure the safety of the fund. Specific measures are as follows: 1, chronic disease patients will borrow their relevant documents to others for medical treatment, false or lost documents, not timely replacement caused by the loss of the fund, immediately cancel the borrower's chronic disease and the current year's participation in the qualification, and recovery of the corresponding funds. 2, fixed-point medical institutions have one of the following circumstances, the penalty is 10 times the amount of violation of the fine, suspended reimbursement of chronic disease, a deadline of three months for rectification, the forfeited money from the security deposit The forfeited amount will be deducted from the deposit and paid to the Municipal Finance Bureau. ① ride on the prescription; ② prescribe large prescriptions, more than one month's worth of medication at a time; ③ to patients with chronic diseases without an annual review of the medical costs of medical treatment; ④ bills do not match the prescription; ⑤ bills are not stamped with a special seal. 3, violation of the financial management system, fraud, issuing false bills maliciously defrauding the New Agricultural Cooperative Fund, in addition to recovering reimbursements for violations, and permanently canceled the chronic disease fixed-point medical qualifications, and hold the The responsibility of the relevant responsible person; suspected of committing a crime, transferred to the judicial organs.

Ten, the provisions of this September 1, 2011 shall come into force.

Linqing New Rural Cooperative Medical Care Management Office

August 26, 2011