摘要
医疗保险基金是人民群众的保命钱、救命钱,是医疗保险制度赖以生存和发展的物质基础,基金的安全关系到整个医疗保险政策的可持续发展和广大参保群众的切身利益。我国医疗保险制度从建立以来,管理部门不断创新基金监管的体制、机制,也取得了积极的管理成效。但是相对于医疗保险事业的快速发展来说,目前对基金的监管和对欺诈骗保行为的惩处力度还显得有些不足,所以必须采取多种举措加以尽快解决。文章分析了当前医疗保险基金监管中存在的问题及产生的原因,进一步提出了建立健全医保基金监管法治体系和监管队伍,建立联防联控的体制机制等一系列的管理对策,不断提高医疗保险基金的使用效率,从而切实保障医疗保险基金的安全和可持续发展。
Medical insurance fund is the people’s life-saving money and life-saving money.It is the material basis for the survival and development of the medical insurance system.The safety of the fund is related to the sustainable development of the whole medical insurance policy and the vital interests of the majority of the insured people.Since the establishment of China’s medical insurance system,the management department has constantly innovated the fund supervision system and mechanism,and has also achieved positive management results.However,compared with the rapid development of medical insurance,the supervision of funds and the punishment of fraud and insurance fraud are still insufficient,so we must take a variety of measures to solve it as soon as possible.This paper analyzes the problems existing in the supervision of medical insurance fund and the causes,and further puts forward a series of management countermeasures,such as establishing and perfecting the legal system and supervision team of medical insurance fund supervision,establishing the system and mechanism of joint prevention and control,so as to continuously improve the use efficiency of medical insurance fund,so as to ensure the safety and sustainable development of medical insurance fund.
作者
王艳茹
WANG Yanru(Medical Insurance Office,The First Hospital of Fangshan District,Beijing 102400,China)
出处
《中国卫生标准管理》
2021年第21期7-10,共4页
China Health Standard Management
关键词
医疗保险
基金监管
基金安全
医疗制度
制度改革
对策分析
medical insurance
fund supervision
fund security
medical system
system reform
countermeasure analysis
