First, the main responsibilities of the medical insurance center
(a) to implement the national, provincial and municipal policies and regulations on medical care, work injury and maternity insurance, and to be responsible for formulating the specific business processes and operational norms of medical insurance in the city and organizing their implementation.
(two) responsible for the management and payment of medical, industrial injury and maternity insurance funds, strictly implement the financial management system of medical, industrial injury and maternity insurance, and ensure the safety and integrity of the fund.
(three) responsible for the preparation of the draft budget and final accounts of the medical, industrial injury and maternity insurance funds, and report all kinds of financial and statistical statements on time.
(four) to establish and improve the early warning system of medical and industrial injury insurance funds, and regularly analyze and predict the income and expenditure of the funds.
(five) to determine the designated medical institutions and retail pharmacies, and sign service agreements with them to guide and manage their business.
(six) responsible for the audit, settlement and disbursement of medical expenses of designated medical institutions and designated retail pharmacies.
(seven) to supervise and inspect the implementation of basic medical insurance regulations and medical services by designated medical institutions and retail pharmacies, coordinate the contradiction between doctors and patients, and protect the interests of insured workers.
(eight) to accept the consultation of the insured units and employees on medical and work-related injury insurance business, publicize the medical, work-related injury and maternity insurance policies, and provide consulting services for the insured employees.
(nine) responsible for the examination and payment of medical, industrial injury and maternity insurance.
(ten) responsible for the city's enterprises and administrative institutions retired cadres medical co-ordination fee collection, medical expenses audit, reimbursement and management.
(eleven) to be responsible for the business guidance of the county and district medical insurance agencies.
(twelve) to undertake other tasks assigned by the municipal administrative department of labor security.
Second, the work items
(1) medical insurance
1, reimbursement of emergency outpatient expenses of insured persons
2, the insured outpatient chronic disease medical expenses reimbursement
3, the insured emergency hospitalization medical expenses reimbursement
4, the insured transfer medical expenses reimbursement
5, the placement of the insured medical expenses reimbursement
6. Secondary reimbursement of civil servants' hospitalization medical expenses.
7. Go through the formalities of medical examination and approval abroad
(2) Industrial injury insurance
1, industrial injury insurance, industrial injury medical treatment payment
2, work-related injury insurance, work-related injury disability (death) treatment payment
3, work-related injury insurance, payment of pensions for dependent relatives of workers who died.
4, industrial injury insurance AIDS configuration fee payment
(3) Maternity insurance
1, maternity insurance maternity registration
2, maternity insurance maternity allowance payment
3, maternity insurance abortion, family planning treatment payment
(four) medical expenses of retired cadres as a whole
1, collection of medical pooling fees for retired cadres
2, retired cadres medical reserve payment
3, retired cadres medical expenses reimbursement
4, retired cadres should be reimbursed for medical expenses.
5, retired cadres resettlement medical expenses reimbursement
6, retired cadres without income families and survivors of medical expenses collection.
7, retired cadres without income families and survivors of medical expenses reimbursement.
Three. Key points of policy
(1) medical insurance
Insured persons will seek medical treatment and purchase medicines at designated places.
The medical insurance for urban workers shall implement the system of designated medical treatment and designated drug purchase. The insured must hold the medical insurance calendar and the medical insurance IC card to the medical institutions and designated retail pharmacies designated by the Municipal Medical Insurance Center for treatment or purchase medicine, and pay by credit card at the payment window provided by hospitals and pharmacies.
legal ground
Article 23 of the Social Insurance Law stipulates that employees shall participate in the basic medical insurance for employees, and the employer and employees shall jointly pay the basic medical insurance premium in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
500 word essay.