The ministry of human resources and social security held a regular press conference at the press briefing room of the people's social security bureau on April 25, April 25.People club department spokesman ai-hong lu directory drug healthcare negotiate relevant situation in the field of medicine, handling insurance fraud, respond to and solve problems such as perfecting the social security system.

First, the first half of the year should be completed

This year people club department released a new version of insurance of primary medical treatment, inductrial injury insurance and maternity insurance drug catalogue, on this basis, according to the central about exploring to establish medical insurance agencies and the requirement of medical institutions, drug supplier negotiation mechanism, people club department to seek to establish negotiating access mechanism is put forward.

How is the negotiation mechanism established?Ai-hong lu said: the clinical curative effect is necessary, but the price is more expensive, according to the current market price included in the directory may bring some risk to the fund's exclusive patent medicine, medicine, determine the scope of the negotiations drugs taken by expert evaluation, organization medicine, pharmacy, public health experts in the field of economics, insurance management to negotiate, negotiate access mechanism is established.After the agreement is reached, the eligible drugs will be included in the catalogue.

How do you negotiate?After consulting experts, selected expert voting procedures, synchronous people club department confirmed the talks more than 40 kinds of medicines, nearly half of those drugs for tumor targeted drugs, covers the common major diseases such as cancer and heart cerebrovascular disease medication, confirmed by the and production enterprise intention to negotiate, ultimately determine the 44 species included in the scope of the negotiations.

When will the first negotiations be announced?The list of negotiations has been announced and the negotiations are being developed.In the process of developing schemes, clubs will be widely listen to learn associated (association), the enterprise and the opinions of the experts and scholars, the scheme will organize experts according to the program after talks to fight for the completion of negotiations in the first half of the work, adjust the schedule with local b directory cohesion.

Prevent fraud and protect the new mechanism

Recent media exposure, shenzhen some public 3 armour hospital doctors and outlaws collusion, by way of prescribing a compliance medicare card cash out.This people club department, said after the aware of relevant information, in guangdong province and shenzhen people club department has carried out investigation and verification, serious processing are jointly with relevant departments.

Spokesman said, through the social security card to obtain medical insurance personal accounts belong to the fraud insurance fraud crime, serious damage to the interests of the masses of ginseng protect personnel, also harm to the sustainable development of the health care system.Preventing and cracking down on health insurance fraud will be a long-term job.The ministry will strengthen supervision measures to further improve the long-term mechanism:

A, in order to strengthen the management of medical insurance fixed-point medical institutions, perfect the medical insurance service agreement, strengthening designated exit mechanism, to explore the health care doctor management, gradually achieve regulatory objects from medical institutions to the medical staff medical service behavior;

Second, we will continue to promote the use of the healthcare smart monitoring system.This kind of monitor and control system has been established in many cities, through the use of monitoring and control system, strengthen the drug for outpatient, hospital, shopping and other kinds of medical service behavior monitoring, in order to strengthen the management of orgnaization of audit audit, regulating the behavior of medical personnel, medical services and ginseng protect personnel to medical behavior;

To study and improve the specific methods of individual accounts, and further block the relevant loopholes in the system;

Four, health care fraud will be punished in accordance with the law violation behavior, strengthen social insurance fraud case investigation and transferred to the work, to promote health care regulation and the effective connection of criminal justice, insurance fraud behavior of fraud found together, investigate together.In addition, the ministry will actively cooperate with relevant departments to strengthen the supervision and supervision of public hospitals and their medical personnel.

Attached: the focus of the 2017 office

We will improve the social security system.Set about to establish the basic endowment insurance treatment to determine urban and rural residents and the opinions of the fundamental annuities normal adjustment mechanism, to guide the integration of urban and rural residents basic medical insurance system, improve the urban residents health jointly with the finance department government subsidies standards, to guide local pilot to advance long-term care insurance, birth insurance and insurance of primary medical treatment to merge the implementation of the pilot.

Second, the social insurance expansion will be paid for, and the comprehensive implementation of the national ginseng guarantee registration plan will be carried out, and the docking and data warehousing of the system will be fully implemented.Now social insurance coverage continues to expand, as of the end of march, the national basic pension, basic medical, unemployment, work injury and maternity insurance, respectively 892 million, 1.012 billion people, 180 million people, 180 million people, 183 million people;The total revenue of the five funds was 1.53 trillion yuan, up 26.9 percent year on year, and total expenditures totaled 1.18 trillion yuan, up 21.7 percent year on year.

Third, strengthen fund investment and supervision and management.By the end of march, Beijing, Shanghai, henan, hubei, guangxi, yunnan, shaanxi, 7 provinces (autonomous regions and municipalities) government and the social security fund council signed the entrusted investment contract.The ministry will use the "information network + supervision" approach to carry out special verification work on the key indicators of old-age insurance.We will accelerate and improve the mechanism for the transfer of social security fraud, and strictly supervise and enforce the law.We will continue to promote investment in the pension fund and strengthen investment supervision.

Fourth, strengthen social insurance management services.Accelerate the long-distance medical networking settlement work, by the end of march, 27 provinces access official national platform, 114 districts (including the province at the corresponding level, the xinjiang production and construction corps) has access, social security card card number to 989 million.Club will advance some provinces and cities to speed up the information system construction and transformation, with the national system of connected access, the orgnaization of social insurance more unity under provincial level, improve the orgnaization of social insurance management and service system.