(Act No. 57 of 10 June 2013 by the People's Government Order No. 57 of 10 June 2013)

In order to prevent and detect violations of the provisions of the basic health insurance system, the security of the basic health insurance fund is guaranteed, and in accordance with legal provisions such as the Social Insurance Act of the People's Republic of China, the Labour Guarantee Monitoring Regulations, this approach is developed in conjunction with the actual practice of the city.

The basic health insurance described in this approach includes basic health insurance for workers, basic health insurance for urban residents and new rural cooperative medical treatment. The basic health insurance fund consists of the basic health insurance fund for workers, the basic health insurance fund for the urban population, and the new Integrated Fund for Rural Cooperation.

The inspection of basic health insurance offences in the city's administration is applicable.

Article 3 Human resources and social security, health administration (hereinafter referred to as “basic health insurance authorities”) assumes oversight functions under the following division of labour:

(i) The Ministry of Human Resources and Social Security Administration is responsible for the supervision of the basic health insurance for workers within the city's administration, the basic health insurance for the urban population. The human resources and the social security administration in all districts (markets), the district of Maghreb are responsible for the supervision of basic health insurance for workers in the region, and the basic health insurance for the urban population.

(ii) The municipal health administration sector is responsible for the supervision of new types of rural cooperative medical treatment within the city's administration. Districts (markets), warehousing, promotional areas, and the area at the end are responsible for the supervision of new types of rural cooperative medical care in the region.

The executive branch, such as civil affairs, finance, food medicine, business and material, should be closely aligned with the implementation of this approach in line with their respective responsibilities.

Article IV provides specific responsibility for the day-to-day management and inspection of basic health insurance in the region. The basic health insurance offices at all levels should enter into the Health Insurance Restructuring Service Agreement with targeted medical institutions, targeted retail pharmacies, regulating the basic health insurance services of targeted medical institutions, targeted terminal retailers.

Article 5

(i) To conduct investigations, inspections and inspections in accordance with the law in places such as a user unit, a targeted medical institution, a terminal retail shop;

(ii) Investigation, interrogation of persons concerned, requiring the investigation, inspection units and individuals to provide documentation relevant to investigations, inspection matters and to provide explanations and clarifications;

(iii) Access to rosters of personnel associated with basic health insurance, accounting books, accounting statements, salary scales and other information;

(iv) To collect evidence materials, including recording, recording, video, photographing or reproduction;

(v) Other measures that may be taken by law.

Article 6. The user units shall, in accordance with the provisions of the Social Insurance Act of the People's Republic of China, the provisional social insurance payment regulations for social insurance payments, the scheme for social insurance payments in the Foi province, promptly carry out basic health insurance for their employees and pay basic medical insurance expenses in full.

Article 7.

Article 8

(i) Carry out (transfer) of his own social security;

(ii) Failing the social security card to take the medical treatment or to hold another person's social security card;

(iii) Conversion of certified materials, such as falsification, conversion and archives, to avoid payment obligations for basic medical insurance payments;

(iv) Stimulating, adapting medical instruments, medical bills, and materials related to basic health insurance;

(v) Removal of medicines, medical equipment, medical material or medical treatment projects that are settled by basic health insurance costs;

(vi) Compilation with the basic health insurance customized services, and collusion of medical insurance projects, air-based social security cards;

(vii) Changes in the conditions for access to health insurance treatment or loss of eligibility for basic health insurance treatment, which are not provided for in the relevant changes, write-off procedures;

(viii) Other violations of the provisions of the basic health insurance system.

In cases where work injury and traffic accidents, etc. are to be paid by third parties, the medical expenses incurred by the basic health insurance fund shall be returned within 60 days of payment of medical expenses by third parties.

Article 9 quantified medical institutions, targeted retail pharmacies should establish a information management system consistent with the operating requirements of the basic health insurance system, as required by the Health Insurance Determination Service Agreement, as well as information management, such as therapeutic project, medicine, medical equipment, etc., to preserve and transmit information at the request of the basic health insurance agency. In the case of a medical institution, a social security card for the medical clinic should be identified, confirming that the social security card information is in line with the management provisions of the prescription and documenting the treatment.

Article 10

(i) The provision of unnecessary medical services, such as repetitive (consistency), repetitive or non-recruitive tests, inspections, treatment, distributing or involuntary hospitalizations, and the inclusion of costs in basic health insurance costs;

(ii) Incorporating medical costs for non-patient or bed-patient inpatient health insurance funds;

(iii) Costs that are not covered by the Basic Medical Insurance Fund, medical treatment projects, medical equipment, living supplies, health care, etc. or are to be covered by the Basic Health Insurance Fund;

(iv) In violation of the scope of essential health insurance or the use of drug-specific provisions to address the cost of basic health insurance by means of ultra-use medicines, repetitive medicines, non-implementation of drugs, or by distributing, modifying prescriptions, for those involved in the insurance;

(v) The payment rate in violation of the provisions of the basic health insurance system is payable;

(vi) Contrarying, changing medical instruments or providing false medical cost-recording certificates, decepting or assisting others in decepting the expenditure of the basic health insurance fund;

(vii) Reimbursement for non-scheduled medical institutions;

(viii) Other violations of the provisions of the basic health insurance system.

Article 11

(i) To assist in the processing of existing basic health insurance funds or the integration of living supplies into the basic health insurance fund;

(ii) Reimbursement costs for retail stores that are not targeted;

(iii) Other violations of the provisions of the basic health insurance system.

Article 12

(i) Violations of the registration of a security unit or individual;

(ii) The payment of basic medical insurance expenses to be paid by unauthorized relief or by non-reducing the write-off of the agent's unit and the participant (company);

(iii) Reimbursement of the standard of payment for the basic health insurance or failure to implement the payment standards for the basic health insurance fund as set out;

(iv) Use of office and work to facilitate the provision of assistance to the insured units, targeted units or individuals for the use of the capital health insurance fund for the town;

(v) Disclosure of information by an owner or by a participant (company);

(vi) Other violations of basic health insurance laws, regulations.

Article 13 rejects, obstructs the application of inspection inspections by the basic health insurance authorities or the basic health insurance agency pursuant to article 5 of this scheme, with a fine of up to 500,000 dollars for the basic health insurance authorities.

Article 14.

In violation of articles 9, 10 and 11 of this approach, the basic health insurance institutions may remove their qualifications for the medical establishment of the relevant targeted medical institutions, the customary retail pharmacies, the medical occupants' suspension of medical insurance for 1 to 12 months; in the case of serious circumstances, the basic health insurance institutions should be removed from the medical treatment agreement they have signed with them, and the basic health insurance authorities should remove their final medical institutions and the eligibility for retail pharmacies.

Article 15 (compared) personnel are suspected of violating article 8 of this approach, and during the investigation, the basic health insurance agencies can change the manner in which their basic health insurance costs are settled.

The final medical institution, the customary retail shops are suspected of violating article 10 and article 11 of the scheme, and during the investigation, the basic health insurance institutions may suspend payment.

Article 16 of the Basic Medical Insurance Agency or its staff are subject to the provisions of article 12 of this scheme, which is modified by the time limit of the responsibility of the basic health insurance authorities and disposes of the person directly responsible and other direct responsibilities by law; causing the loss of the basic health insurance fund to be paid or to recover the basic health insurance funds that have been paid; liability is assumed by law for the loss of the user unit, the targeted medical institution, the terminal retail store, the insured (concord).

Article 17, the basic health insurance agency, in the course of routine inspections, found the identification of targeted medical institutions, targeted retail stores or their staff members in violation of the regulations of the operation, should be transferred to the relevant administration.

Targeted medical institutions, customised retail stores, basic health insurance institutions or their staff, insured persons and other personnel are charged with receiving basic health insurance funds, which are serious offences, and the basic health insurance authorities should be transferred to the judiciary in a timely manner and criminally liable by law.

Article 18 is located outside the present city's administrative area, and the relevant administrations transferred to the location are treated in accordance with the provisions of this scheme by the targeted medical institutions that have concluded basic health insurance services agreements with the health insurance agencies in the city.

Article 19 encourages units and individuals to report violations of the provisions of the basic health insurance system. The units or individuals who report the facts and provide the main axes and evidence for the identification of major offences should be rewarded by the basic health insurance authorities or the basic health insurance agency.

Article 20 of the Basic Medical Insurance Agency found that the basic health-care insurance funds, such as the Basic Health Insurance Fund, were deceived and should be transferred to the relevant fund management.

Article 21, this approach has been implemented effective 1 August 2013.