9鼎彩票

9鼎彩票
>>政策文件

关于建立打击欺诈骗取医疗保障基金长效机制的通知

2018-05-17 10:00 字号: 【 打印本页

9鼎彩票GEXIANSHIQUYILIAOBAOZHANGJU、WEISHENGJIANKANGJU、GONGANJU、SHICHANGJIANDUGUANLIJU:

为切实加强医疗保障基金监管,整顿医疗保障运行秩序,规范医保就医诊疗行为,加快推进打击欺诈骗取医疗保障基金工作常态化、制度化、持久化,促进医保诚信体系9鼎彩票,实现医保基金安全完整,现就持续做好医疗保障基金监管工作通知如下。

一、提高站位,明确工作目标

9鼎彩票YILIAOBAOZHANGJIJINSHILAOBAIXINGDEJIUMINGQIAN。DANGZHONGYANG、GUOWUYUANLINGDAODUOCIZUOCHUZHONGYAOZHISHI,YAOJIAQIANGYIBAOJIJINJIANGUAN,WUSHIYIBAOJIJINCHENGWEIXINDE“TANGSENGROU”,RENYOUPIANQU,YAOYIFAYANSUCHACHUGEZHONGPIANQUYIBAOJIJINXINGWEI。SHIXIANLIANGJIYILIAOBAOZHANG、WEISHENGJIANKANG、GONGAN、SHICHANGJIANDUGUANLIBUMENYAOCHONGFENRENSHIYIBAOJIJINJIANGUANGONGZUODEZHONGYAOXING、JINPOXINGHEJIANJUXING,BAJIAQIANGYIBAOJIJINJIANGUANGONGZUOZUOWEIDANGQIANHEJINHOUYIGESHIQIYIBAOGONGZUODESHOUYAORENWUHEZHONGZHONGZHIZHONG,QIANGHUAZERENDANDANG,SHIZHONGBAOCHIDAJIQIZHAPIANBAOXINGWEIDEGAOYATAISHI。YAOJUJIAOYILIAOBAOZHANGLINGYUWEIFAWEIGUIHEQIZHAPIANBAOXINGWEI,YIXIEYIGUANLIYILIAO(HU)JIGOU、LINGSHOUYAODIAN、GONGZUORENYUANHECANBAORENYUANWEIZHUYAOJIANGUANDUIXIANG,YIZHUYUAN、MENZHENJIUYIHELINGSHOUYAODIANGOUYAO、YIDIYILIAO9DINGCAIPIAOHEFEIYONGWEIZHUYAOJIANCHANEIRONG,JIADADUIPIANQUYIBAOJIJINXINGWEIDEFANQIZHALIDU,DADAOXUANCHUANFAGUI、QIANGHUAGUANLI、JINGHUAHUANJING、ZHENSHEFANZUIDEMUDE。TONGSHIZENGQIANGYIHUANSHUANGFANGZUNSHOUYILIAOBAOZHANGGUANLIGUIDINGHELVXING9DINGCAIPIAOXIEYIDEZHUDONGXINGHEZIJUEXING,JINYIBUWANSHANYILIAOBAOZHANGZHILITIXI,SHIXIANYUANTOUFANGFAN,BAOZHANGYIBAOJIJINANQUAN,RANGDANGWEI、ZHENGFUFANGXIN,RANGRENMINQUNZHONGMANYI。

ER、ZHONGDIANGONGZUONEIRONG

(YI)ZHONGDIANJIANDUJICHANEIRONG

1、YILIAO(HU)JIGOU。TONGGUOXUJIAXUANCHUAN、YICHATIDENGMINGMUYOUDAO、PIANQUCANBAORENYUANZHUYUANXINGWEI;LIUCUN、DAOSHUA、MAOYONGCANBAORENYUANSHEHUIBAOZHANGKAXINGWEI;RENZHENGBUFU、EYIGUACHUANGZHUYUAN、XUGOUYILIAO9DINGCAIPIAO、WEIZAOYILIAOWENSHUHUOPIAOJUXINGWEI;XIEZHUCANBAORENYUANKAIJUYAOPINYONGYUBIANXIAN、TAOQUYIBAOJIJINXINGWEI;XUJI、DUOJIYAOPIN、ZHENLIAOXIANGMU、YIYONGHAOCAI、YILIAO9DINGCAIPIAOSHESHIFEIYONGXINGWEI;CHUANHUANYAOPIN、QIXIE、ZHENLIAOXIANGMUXINGWEI;FENJIESHOUFEI、CHAOBIAOZHUNSHOUFEI、ZHONGFUSHOUFEI、TAOYONGXIANGMUSHOUFEIXINGWEI;BUHELIZHENLIAOHEQITAWEIFAWEIJIJIQIZHAPIANBAODENGXINGWEI。

9鼎彩票2、LINGSHOUYAODIAN。LINGSHOUYAODIANYAOPINDEJINXIAOCUNTAIZHANG,SHIFOUCUNZAICHUANHUANYAOPIN、WUPIN,SHUASHEBAOKAGOUMAIFEIYIBAOYONGPINHETAOXIANDENGTAOQUYIBAOJIJINDEXINGWEI。

9鼎彩票3、CANBAORENYUAN。YIDIJIUYISHOUGONGBAOXIAO、JIUZHENPINCIJIAODUO、SHIYONGYIBAOJIJINJIAODUODECANBAORENYUANJIUYIGOUYAOXINGWEI。YISHIFUCHADAEYILIAOFEIYONGPIAOJU。DANCIZHUYUANYILIAOFEIYONGCHAOGUO5WANYUANDEPIAOJUQUANMIANFUCHA,JIEHEZHINENGJIANKONGSHUJU,5WANYUANYIXIAPIAOJUCHOUYANGFUCHA;DUIFANFUQINGZHENGZHUYUANBINGREN,CHOUCHAYIDUANSHIJIANNEIZHUYUANBINGLI,DUIBIQIANHOUBINGSHI、JIANCHA、HUAYANZILIAODEYIZHIXING。ERSHIFUCHAGUOGAOMENZHENFEIYONGDEZHENSHIXING。GEXIANSHIQUDUIMENZHENFEIYONGPAIMINGQIAN100WEIDECANBAORENYUANJINXINGQUANMIANFUCHA。JIEHEZHINENGJIANKONGXITONG,DUIQITACANBAORENYUANJIUYIXINGWEICHOUYANGFUCHA。

(ER)JIANLIJIANQUANJIJINJIANDUJIANCHAZHIDU。YISHISHIXIANLIANGJIYILIAOBAOZHANGBUMENYAOYANGEANZHAOGUIDING,QIANGHUAYUYIYAO(HU)JIGOUJINXINGXIEYIGUANLI,DUISHENQINGXIEYIGUANLIDEYIYAO(HU)JIGOU,YAOYANGEANZHAOGUIDINGDECHENGXUHEBIAOZHUNJINXINGPINGGU,NARUYIBAOGUANLIDEYIYAOJIGOUYAOQUANBUQIANDING《9DINGCAIPIAOXIEYI》,YAOJIANLIDUIQIANYUEYIYAO(HU)JIGOUTIGONGHEFASHENGDE9DINGCAIPIAOXINGWEI、YILIAOFEIYONG、YILIAOWENSHUYIJIQITAXIANGGUANSHUJUZHIBIAODENGNEIRONGJINXINGJIANDUDEJICHAZHIDU。YISHIXIANSHIQUYAOXINGCHENGRI、ZHOUCHIXUBUJIANDUANDERICHANGJIANDUJICHA,YUE、JIBUDINGQIDEJIZHONGCHOUCHA,SHIJUDINGQIZUZHIKAIZHANJIZHONGJICHAYUBUDINGQILIANHEJIAOCHAJICHAXIANGJIEHEDEJIANDUJICHAZHIDU;ERSHIGEXIANSHIQUYAODUISHANGJIJIAOBAN、ZISHENSHOULI、YOUGUANBUMENZHUANJIAO、YIDIXIEBANDENGTOUSUJUBAOXIANSUO,JIANLIYOUZHENDUIXINGDEDIAOCHACHULIJIZHI;SANSHIDUIFAXIANDEQINGXIANGXINGWENTI、YUQINGFANYINGJIZHONGDEHUOQITAKENENGYINGXIANGJIAODADEWENTIJIANLIZHUANXIANGDIAOCHAJIZHI;SISHIYAOQUANMIANJIANLISUIJIDINGSHIJIAN、SUIJIDINGJIGOUDEFEIXINGJIANCHAZHIDU;WUSHIGULITANSUOKAIZHANDISANFANGJIANDUJICHASHIDIANGONGZUOJIZHI。TONGGUORICHANGJIANDUJICHAYUZHUANXIANGDIAOCHAXIANGJIEHE,DINGQIJICHAYUFEIXINGJIANCHAXIANGJIEHE,MINGCHAYUANFANGXIANGJIEHEDENGBUTONGFANGSHI,CHIXUJIADADUIQIZHAPIANQUYIBAOJIJINXINGWEIDEDAJILIDU,DUIXIAQUNEIXIEYIGUANLIDEYIYAO(HU)JIGOUHECANBAORENYUANSHIXINGJIANDUWUSIJIAO,SHIZHONGBAOCHIDAJIQIZHAPIANBAOXINGWEIDEGAOYATAISHI。

(SAN)JIANLIGAOSUZHIZHUANYEHUAJIJINJIANDUDUIWU。QIZHAPIANQUYIBAOJIJINYINBIXINGQIANG,CHACHUNANDUDA,YILIAO9DINGCAIPIAODETESHUXINGJIJIANDUGUANLIBUMENTICHULEGENGGAO、GENGZHUANYEDEYAOQIU。GEXIANSHIQUYAOZHUDONGSHIYINGGONGZUOXUYAO,JIAQIANGYIBAOJIJINJIANDUGUANLIDUIWU9DINGCAIPIAO,YOUHUAYIXUE、YAOXUE、HULIXUE、SHENJIHEJISUANJIDENGZHUANYERENYUANPEIBEI,JINYIBUTISHENGJIJINJIANDUGUANLIRENYUANSHULIANGHEZHILIANG,CHONGSHIQUANSHIYILIAOBAOZHANGJIJINJICHAZHUANJIAKU,JIANLIYIZHIZHENGZHISUZHIGAO、YEWUNENGLIQIANGDEZHUANYEHUAJIANDUDUIWU。

(SI)TUIJINJIJINZHINENGJIANKONGXINXIHUA9DINGCAIPIAO。QUANMIANQIYONGYIBAOZHINENGJIESUANPINGTAI,DUIJIEXIEYIGUANLIDANWEIDEHIS XITONGHEJINXIAOCUNXITONG,SHISHIDIAOQUHEJIANKONGBINGANSHOUYEXIANGGUANXINXI、MENZHENCHUFANGHEJINXIAOCUNDENGXIANGGUANSHUJU。QUANMIANTUIGUANGYILIAOFEIYONGXIANSHANGZHINENGSHENHE,SHIXIANLIANGJIYIBAOBUMENJUNYAOCHENGLIYIBAOZHINENGSHENHEFENXIXIAOZU,QUEDINGYIBAOSHUJUJIANKONGFENXIFANGXIANG,WANSHANJIANKONGGUIZE,XIHUAJIANKONGZHIBIAO,CHONGSHIJIANKONGZHISHIKU,SHIXIANYIBAOFEIYONGJIESUANCONGBUFENSHENHEXIANGQUANMIANSHENHEZHUANBIAN,CONGSHIHOUJIUZHENGXIANGSHIQIANTISHI、SHIZHONGJIANKONGYUJINGZHUANBIAN。

(WU)JIANLIYILIAOXINYONGTIXI。JIANLIYIYAO(HU)JIGOUJIQIFADINGDAIBIAOREN、YIBAOYISHIJIQITACONGYERENYUANHECANBAORENYUANXINYONGHEIMINGDANZHIDU。TONGGUOGUIFANYIYAO(HU)JIGOUHEYIBAOYISHIJIQITACONGYERENYUANDEYILIAOXINGWEI,YINDAOJIGOU、CONGYERENYUANHECANBAORENYUANKESHOUCHENGXIN、GUIFANXINGWEI,BUDUANTIGAOFALVYISHI、YEWUSUZHI、9DINGCAIPIAOZHILIANGHE9DINGCAIPIAOSHUIPING,TIGAOYILIAOJIGOUHECONGYERENYUANLVXING《9DINGCAIPIAOXIEYI》DEZIJUEXINGHEZHUDONGXING,DUIWEIFAWEIGUIDEYIYAO(HU)JIGOUJIQIFADINGDAIBIAOREN、YIBAOYISHIJIQITACONGYERENYUANHECANBAORENYUAN,YAOANZHAO《9DINGCAIPIAOXIEYI》DEYUEDINGHEXIANGGUANGUIDINGYIFAYIGUICHULI;DUISHOUDUANELIEHUOJINEJUDADEPIANBAOXINGWEIFUYOUZHIJIEZERENDEQIYEFARENHEZERENRENMINGDAN,YAOTUISONGZHISHIJIGONGGONGXINYONGXINXIPINGTAI,ZAIQUANSHIFANWEINEIKAIZHANLIANHECHENGJIE,QIESHIGOUZHU“YICHUSHIXIN、CHUCHUSHOUXIAN”DEXINYONGJIANGUANGEJU。

9鼎彩票(LIU)CHANGTONGQUNZHONGJUBAOTOUSUQUDAO。SHIXIANYIBAOBUMENYAOSHELI、GONGBUWEIFAWEIJIJUBAOTOUSUDIANHUA,GONGZUOSHIJIANYAOYOUZHUANRENJIETING,JISHISHOUJIGEFANGXIANSUO,HUIYINGCHULIGELEIWENTI;GULISHIMINGJUBAO,ANYAOQIUJIANLITOUSUJUBAOJIANGLIJIZHI,JIANLIJUBAOTOUSUBAOMIZHIDU,YIFAYIGUIBAOHUJUBAORENDEGERENXINXIBUXIELU,BAOZHANGJUBAORENDEHEFAQUANYI。

(QI)JIADACONGYANCHENGJIELIDU。GEJIJINGBANJIGOUZAIRICHANGJIANDUJICHA、ZHUANXIANGDIAOCHA、FEIXINGJIANCHASHIFAXIANDEWENTIXIANSUO,YAOJINKUAILIANDIAOCHA,YIJINGCHASHI,YAOZONGHEYUNYONGXIEYIGUANLIHEXINGZHENGCHUFASHOUDUAN,YANSUZHUIJIUZEREN。YIJUXIEYIJIYUYUETAN、XIANQIZHENGGAI、ZANTINGJIESUAN、JUFUFEIYONG、ZANTINGXIEYI、JIECHUXIEYIDENGCHUFA,BINGYIFAJIYUPIANQUJINEERBEIYISHANGWUBEIYIXIAFAKUANDEXINGZHENGCHUFA。XIANSHIQUJIECHU9DINGCAIPIAOXIEYIDEYIYAO(HU)JIGOU,YAOSHANGBAOSHIYIBAOZHONGXINBEIAN。BEIJIECHU9DINGCAIPIAOXIEYIHUOXIEYIYOUXIAOQINEILEIJI3CIBEIZANTINGXIEYI、ZANTINGXIEYIQIJIANWEIANSHIXIANYAOQIUZHENGGAIHUOZHENGGAIBUDAOWEIDEYIYAO(HU)JIGOU,SANNIANNEIBUDEZAICISHENQINGYIBAODINGDIAN;ZHIJIEZERENRENYUANYOUZHIYEZIGEDE,ZHUGUANBUMENYIFADIAOXIAOQIZHIYEZIGE;DUICHASHIJUYOUPIANQUYIBAOJIJINDENGWEIGUIXINGWEIHUOFUYOUZERENDEYIBAOYISHI,SHIQINGJIEYANZHONGCHENGDUJIYUTINGZHIYIZHIWUNIANYIBAOJIESUANZIGEDECHULI,BINGJIANGWEIGUIXINGWEITONGBAOWEISHENGJIANKANGBUMEN;DUIJUYOUPIANQUYIBAOJIJINXINGWEIDECANBAORENYUAN,JIYUZANTINGYIBAOZHIJIEJIESUANCHULI。DUICHASHIDEWEIFAWEIGUIXIANSUO,JISHITONGBAOXIANGGUANBUMEN,YOUXIANGGUANBUMENANGUIDINGZUOCHUXINGZHENGCHULIHUOZHUIJIUDANGJIZHENGJIZEREN;DUISHEXIANFANZUIDE,JISHIYISONGSIFAJIGUAN,YIFAZHUIJIUXINGSHIZEREN。

SAN、BAOZHANGCUOSHI

9鼎彩票(YI)JIAQIANGZUZHILINGDAO。YILIAOBAOZHANG、WEISHENGJIANKANG、GONGAN、SHICHANGJIANDUGUANLIBUMENYAOGAODUZHONGSHIDAJIQIZHAPIANQUYILIAOBAOZHANGJIJINGONGZUO,SHIXIANLIANGJIDOUYAOCHENGLIXIANGYINGDEGONGZUOLINGDAOXIAOZU,MINGQUERENYUANZUCHENGHERENWUMUBIAO,XIAOZUBANGONGSHISHEZAIYILIAOBAOZHANGJU,FUZERICHANGJIANDUJICHA、TOUSUJUBAOXIANSUOCHACHU、ZHUANXIANGDIAOCHAHEFEIXINGJIANCHADEZUZHIGONGZUO。

9鼎彩票(ER)XINGCHENGGONGZUOHELI。YIBAOBUMENYAOQIESHIFAHUIHAOQIANTOUZUZHIXIEDIAOZUOYONG,FUZEDUIXIEYIGUANLIYILIAOJIGOUHELINGSHOUYAODIAN9DINGCAIPIAOXINGWEIHECANBAORENYUANJIUYIGOUYAOXINGWEIDEJIANDUJICHA、KUASHENGPIAOJUDEHECHA、DUIJIANDUJIANCHAZHONGFAXIANDEWEIFAN9DINGCAIPIAOXIEYIDEXINGWEISHISHIXIEYICHULI、XINGZHENGCHUFA,DUISHEXIANWEIFAWEIJIDE,SHIQINGXINGFENBIEYISONGGONGANJIGUANHUOJIWEIJIANCHAWEICHULI。

WEISHENGJIANKANGBUMENCANYUDUIXIEYIGUANLIYILIAOJIGOUYILIAOXINGWEIDEJIANDUJICHA,DUIJIANDUJICHAZHONGFAXIANDEWEIGUIYILIAOJIGOU、WEIGUIYIWURENYUANYIFAYIGUIJINXINGCHULI。

GONGANBUMENCANYUTOUSUJUBAOANJIAN(XIANSUO)DECHACHU、YUQINGFANYINGJIZHONGWENTIDEDIAOCHAHEFEIXINGJIANCHA。BANLIYIBAOLINGYUFASHENGDEYIFAYOUGONGANJIGUANGUANXIADEXINGSHIANJIAN,HUITONGXIANGGUANBUMENJIAQIANGYIBAOLINGYUXINGZHENGZHIFAYUXINGSHISIFADEXIANJIE。

9鼎彩票SHICHANGJIANDUGUANLIBUMENCANYUDUIDINGDIANLINGSHOUYAODIANDEJIANDUJICHA。

9鼎彩票GEBUMENYAOXIANGHUZHICHI,MIQIEHEZUO,HUTONGXINXI,PEIHELIANDONG,TONGSHICHONGFENFAHUISHANGYEBAOXIANGONGSIDISANFANGJICHADEZUOYONG,XINGCHENGGONGZUOHELI,GONGTONGTUIJINDAJIQIZHAPIANQUYIBAOJIJINXINGDONGLUODAOSHICHU,QUDESHIXIAO。

(SAN)YINGZAOYULUNFENWEI。LIYONGHAOCHUANTONGMEITIHEXINMEITI,JIAQIANGYIBAOXIANGGUANFALVFAGUIHEZHENGCEDEXUANCHUANLIDU。JIAQIANGJINGSHIJIAOYU,MIANXIANGQUANSHEHUIJIZHONGXUANCHUANYIPIQIZHAPIANBAODIANXINGANLI,YINDAOCANBAORENYUANZIJUEDIZHI、JIJIJUBAOQIZHAPIANBAOXINGWEI,QIESHIBAOZHANGYIBAOJIJINYUNXINGANQUAN。

(SI)QIANGHUAZERENZHUIJIU。XIANSHIQUYIBAOBUMENYINGQIESHILVXINGDUIXIAQUNEIXIEYIGUANLIYIYAO(HU)JIGOUDEJIANDUGUANLIZEREN,ZUOWEIJIANGUANHEDAJIQIZHAPIANQUYILIAOBAOZHANGJIJINXINGWEIDEDIYIZERENREN,DUIXIAQUNEIXIEYIGUANLIDEYIYAO(HU)JIGOUYAOZUODAOSHISHIQUANFUGAIJIANGUAN,YAOQIESHIZUODAOYOUBAOBICHA、CHABIYOUGUO,DUIYINJIANGUANBUDAOWEIDAOZHIYIBAOJIJINBEIQIZHAPIANQUDE,HUODUISHOULIDETOUSUJUBAOXIANSUOJINXINGTUOYAN、TUIWEI、DIAOCHABUDAOWEIBUCHEDIYIJIZHENGGAI、CHULI、ZHUIZEBUDAOWEIDE,JIANGJINXINGWENZE。

(WU)JIANLIDIAODUTONGBAOZHIDU。XIANSHIQUYAOZHIDINGJUTIDERICHANGJIANDUJICHAGONGZUOSHISHIFANGAN,JIANDUJICHAGONGZUOQINGKUANGYAOYOUZHUANRENANYUESHANGBAOSHIYILIAOBAOZHANGJU。DUIRICHANGJIANDUJICHABUDAOWEI、WEIZAIGUIDINGSHIXIAONEIBANJIESHANGJIJIAOBANANJIAN(XIANSUO)HUODIAOCHACHULIBUDAOWEIDE、YUQINGFANYINGJIZHONGYINGXIANGJIAODADEWENTIWEIJISHIDIAOCHACHULIDE、WEIKAIZHANFEIXINGJIANCHADENGQINGKUANGDE,SHIJUJIANGDINGQIJINXINGTONGBAO。

责任编辑:医保局
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