On June 2, the medical insurance fund had a low level, and some of the insurance coverage was at risk. The implementation of the medical insurance reimbursement policy is not in place; In the case of insurance, the insurance fee is still there, and more than 1,700 enterprises in luoyang owe their health care to the staff of 240 million yuan... The provincial bureaus of the zhoukou, in luoyang, zhumadian, kaifeng in 2015 and 2016 in the first half of the medical insurance fund (hereinafter referred to as the medical insurance fund) usage audit found problems. On June 1, the provincial audit office released the results of the audit. 

 

Grade: the health insurance system is more robust 

 

Two levels of public health clinics in counties and townships cancel the drug addition 

 

We have learned, in August 2016 to October, a local audit teams provincial bureaus to kaifeng, luoyang, zhoukou, zhumadian and other four city at the corresponding level and subordinate eight counties in 2015 and 2016 in the first half of the medical insurance fund audit. Audit is the main content of the urban employee basic medical insurance (hereinafter referred to as the worker health care), basic medical insurance for urban residents (hereinafter referred to as the urban residents health care), a new type of rural cooperative medical care system (hereinafter referred to as the new farming), serious illness insurance policy system between urban and rural areas to carry out the situation, the reform measures to promote the usage situation and the fund management. 

 

The audit results show that by the end of June 2016, four areas a complete coverage of basic medical insurance system implementation, some areas have been merged the implementation of a unified urban and rural residents basic medical insurance system. All the areas in the region have implemented the urban and rural insurance system, covering about 57586 people. 

 

As of June 2016, the area of the trial was abolished in accordance with the requirements of comprehensive reform of county-level public hospitals. The local health clinics of each township have also eliminated the addition of medicines in accordance with the requirements of the reform of the medical and health system at the grass-roots level. Most of the planning areas have implemented the immediate settlement of medical care in the province. 

 

The problem: health care policy is not strictly enforced 

 

In luoyang, 1757 companies paid $240 million for a year and a half 

 

In the implementation of the health care policy, the health care fund has a low level of planning and the risk of paying for some of the health care. For example, as of June 2016, there are 11 unified management areas in the area of the staff health insurance in the city, which is lower in the overall plan. 

 

Individual local village health room general consultation fee is not paid in full. Farmers like kaifeng optimization methodology for new office not strictly implement village clinics in the allowances for 7 yuan fee each time, lead to appropriate village clinics 2015 fewer general fee subsidy of 2.2874 million yuan. 

 

The relevant medical insurance system is not implemented. As of the city of zhoukou city and the city of the city of the city of the city, as of June 2016, there has been no overall plan for the establishment of a medical clinic for urban residents. 

 

The insurance reimbursement policy of kaifeng medical insurance will not be in place, and the expenses for the medical treatment of urban and rural medical insurance will be less reimbursed. 

 

In the case of the reform of healthcare reform, the implementation of the medical insurance reimbursement policy is not in place; Medical institutions do not purchase high-value consumables through centralized purchasing platforms. The medical insurance of the worker and the urban resident insurance does not fully realize the immediate settlement of the medical care in the province. 

 

In the management of the insurance fund, the insurance fee for the employees of the insured unit is still in existence. The total of 1,757 companies in luoyang in 2015 and the first half of 2016 totaled 240 million yuan. Individual local insurance funds have not received preferential interest rates; Individual agency medical insurance premium income does not pay the financial special account in time. 

 

In accordance with the above audit conditions, the audit authorities have issued audit reports and issued audit decisions according to law. In the case of the audit, the relevant places attach great importance and make positive changes. As of the end of December 2016, the funds had been recovered from the embezzlement, embezzlement and expansion of the scope of expenses, including 2175.77 million yuan, and the financial aid funds were allocated 273.37 million yuan. Other problems are being overhauling.