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医疗保障法草案首次提请审议,强化基金监管惩戒力度

 
Issuing time:2025-06-27 11:36Author:编辑部
医疗保障法草案首次提请审议,

好的牙·讯|据新华社报道,医疗保障法草案近日提请十四届全国人大常委会第十六次会议首次审议。此次提请审议的草案共7章50条,系统性地规定了医疗保障体系框架、基金运行管理、服务优化以及监督管理等关键内容,目的是依法健全全民基本医保制度,有效保障参保人合法权益。

国家医保局局长章轲介绍,草案专门设置章节系统规定医疗保障体系框架,明确了职工基本医疗保险、城乡居民基本医疗保险和生育保险的参保范围、筹资方式和待遇保障等核心内容。

在基金安全管理方面,草案规定医疗保障基金执行国家统一的财务和会计制度,确保资金专款专用,并纳入社会保障基金财政专户管理。同时,草案明确制定基本医疗保险基金支付范围的原则要求,立足基金承受能力,满足参保人员合理医疗需求,并规范定点医药机构和参保人员的医疗保障基金使用行为。

在服务优化方面,草案提出建立健全医疗保障公共服务体系,规范统一医疗保障公共服务事项清单,实现医疗保障公共服务城乡全覆盖。此外,草案还要求建立健全基本医疗保险、补充医疗保险、医疗救助等相衔接的医药费用直接结算机制,完善异地就医医药费用直接结算制度。

为加强监督管理,草案明确建立人大监督、部门监管、社会监督相结合的监督体系,畅通举报投诉渠道;对基金使用实施动态智能监控,提高监督效能;综合运用罚款、暂停涉及基金使用的医药服务、暂停医药费用联网结算、解除服务协议等多种措施,加大对违法行为的惩戒力度。

(本内容图源:国家医保局官网)

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