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Pastoral Area Of Inner Mongolia Autonomous Region, The New Rural Cooperative Medical Management

Original Language Title: 内蒙古自治区新型农村牧区合作医疗管理办法

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Health management approach for new rural pastoral areas in the self-government region of Mongolia

(The first ordinary meeting of the Government of the people of the Autonomous Region of Mongolia, held on 23 January 2013, considered the adoption of the Decree No. 194 of 20 February 2013 by the Government of the People's Government of the Autonomous Region of Mongolia, effective 1 March 2013)

Chapter I General

Article 1 establishes this approach in the light of the relevant legislation, in order to guarantee access to basic medical services for agricultural pastoralists and to preserve the legitimate rights and interests of medical workers involved in new rural pastoral areas (hereinafter referred to as participants).

Article 2 addresses new rural pastoral cooperative medical treatment as described in this approach, which refers to the voluntary participation of agricultural pastoralists, in accordance with the principles of public justice, fair access, fertilization and basic guarantees, and to fund-raising systems for rural pastoral residents, including personal contributions, collective support, government subsidies.

Article 3.

Article IV implements a new integrated system of cooperation in rural pastoral areas.

Article 5 Governments of more people at the flag district level should incorporate new rural pastoral cooperative medical work into local national economic and social development planning, establish health-care coordination mechanisms for good new rural pastoral areas, and mobilize new rural pastoral cooperation funding.

Article 6 The new rural pastoral cooperative medical institutions (hereinafter referred to as the executing agency) are specifically responsible for the day-to-day work of new rural pastoral cooperative medical care.

Relevant sectors such as development and reform, finance, audit, civil affairs, human resources and social security, farming and pastoral industries have been able to work on new types of rural pastoral cooperation in accordance with their respective responsibilities.

Article 7

The Villagers' Committee, the Residential Commission, assisted the Government of the people of the town of Suwood and the street offices to cooperate in health care in new rural pastoral areas.

Article 8. The Government of the people at the flag district level and its relevant authorities should provide recognition and incentives for units and individuals that have made a prominent contribution to the work of health care in new rural pastoral areas.

Part II Participants

Article 9

Other basic health insurance coverage has been attended without access to new rural pastoral cooperative medical treatment.

Article 10 Residents who do not participate in the health insurance of the urban population and who live in the town of Sugar may voluntarily choose to participate in the medical treatment of new rural pastoral areas of their origin or residence.

Article 11 Persons with rural pastoralities in self-government zones who have no residence for more than one year in the area of self-government and who do not participate in new rural grazing areas in the household can voluntarily choose to participate in cooperative medical treatment in new rural pastoral areas where they are present.

Article 12. Children of rural pastoral origin and secondary school students shall participate in new forms of rural pastoral cooperation with their father, mother or other guardians.

When a person participating in a new rural grazing area cooperates with medical care, according to the prescribed payment, the office shall register it as a participant and receive medical treatment for new rural pastoral areas in the annual payment period, and shall not be considered automatically abandoned as the payment.

Article 14.

Article 15 participants have the following rights:

(i) Reimbursement for medical expenses, as prescribed;

(ii) To search, collate payment and obtain reimbursement;

(iii) Understanding the mobilization and use of new rural pastoral cooperative health funds;

(iv) Participation in cooperative medical supervision in new rural pastoral areas;

(v) Other rights under the law, regulations.

Article 16 participant fulfils the following obligations:

(i) To pay in full and on time the personal costs of medical cooperation in new rural pastoral areas;

(ii) To comply with the regulations governing cooperation in new rural pastoral areas;

(iii) Provision of information and information on medical and medical expenses, if any;

(iv) Other obligations under laws, regulations.

Chapter III Fund mobilization and management

Article 17

(i) The payment of expenses by the participant;

(ii) Finance grants;

(iii) Funding for collective economic organizations in rural pastoral areas;

(iv) Social donations;

(v) Interest income;

(vi) Other sources.

Article 18

Article 19

Article 20, the Government of the people of the town of Suhwood, the street office or the villagers commission entrusted by it, the Residential Commission, which is the personal collection unit, may entrust financial institutions with the payment of their contributions.

Payments should be made to the payer for the unification of the earmarked contributions received by the financial sector of the self-government zone, and funds were transferred to the new rural pastoral cooperative medical fund.

Article 21

The low-insurance targets in rural pastoral areas, with a focus on personal contributions to new rural pastoral cooperatives, are funded by the Medical Relief Fund of the Civil Service, in accordance with the criteria not less than 50 per capita dollars.

In addition to the central financial support fund, new rural pastoral cooperative funding should be shared by self-government, allies and flag-level finances.

Article 23 Funds at all levels should be transferred in a timely and full manner to the financial specialties of the new rural pastoral cooperative fund in the integrated region, in accordance with the time specified.

Article 24 of the new rural pastoral Cooperation Medical Fund is governed by two line lines of income and expenditure, exclusive storage, separate construction, specialization, and no unit or individual may be intercepted, misappropriated and expropriated.

Chapter IV Use and treatment of funds

Article 25

Article 26 Economies should draw risk funds from new rural pastoral cooperative health funds in accordance with the provisions, which should not exceed 3 per cent of the total funds raised by the year, and the calendar year shall not exceed 10 per cent of the total annual funds.

Article 27 balances of the new rural pastoral Cooperation Fund for the current year of the Fund (which includes a risk fund) shall not exceed 15 per cent of the total amount of the Fund during the year, and the accumulated balances for calendar years shall not exceed 25 per cent of the total fund raised in the previous year and shall be compensated again in part by the participant who has received a medical fee.

A new rural pastoral cooperative health fund is divided into two components of the Integrated Inpatient Fund and the Interview Integrated Fund. The proportion of the use of the Integrated Fund should be less than 70 per cent of the annual funds, and the proportion of the Fund's use should be less than 20 per cent of the annual funds and adjusted in the context of funding and related provisions.

Article 29 includes the maximum annual payment limit for hospitalization expenses covered by the new rural pastoral cooperation fund.

Article 33 includes the payment of inpatient medical expenses within the new rural pastoral cooperation fund, which is reimbursed according to the proportion of the fees paid, and the following portion of the payment line is borne by the participant on his own initiative.

Article 31 participant's fees in the context of the payment of the funds incurred by the medical facility at the point of diagnosis are reimbursed according to the prescribed proportion.

After the payment of the hospitalization medical expenses by the participant in article 32, the reimbursement portion is made by the targeted medical institution, which is reimbursed on a regular basis with the targeted medical institutions.

Article 33 may provide necessary advance funds for targeted medical institutions.

In accordance with the principle of medical treatment, participants can choose to consult with the new rural pastoral medical institutions in the integrated area.

Article XV participated in the need for referrals to inpatient care outside the integrated area and should be sent by a referral certificate from the sub-office appointed by the institution and the above-listed medical institutions, and by referral procedures to the agencies of the host region.

Article 36 participates in medical treatment for special reasons, such as acuteness, risk, reorientation or first aid, outside the integrated area or non-scheduled medical institutions, or their clients shall inform, within five days, the agencies involved in the area to which they belong.

Article 337, which is one of the circumstances of article 335 and thirty-sixth of this approach, may be reimbursed by the participating person for medical expenses by the office of the integrated area, which shall be reviewed by the institution within 30 days, with the object of verification that there is a certain degree of difficulty, may be extended beyond 60 days.

Article 338 Reimbursement for individuals who have been paid for medical care in rural pastoral areas after a new type of rural pastoral cooperation is paid by the local civil service according to the prescribed proportion.

The Government's health administration in the self-government area should develop a directory and a directory for new rural pastoral cooperative medical medicines reimbursements and medical projects, and be made available to society.

Article 40 Reimbursement for cooperation in new rural pastoral areas, scope of reimbursement, rates of reimbursement are adjusted and made available to society in the integrated area of health, the financial sector on the basis of funding.

In one of the following cases, medical expenses are not included in the reimbursements of the new rural pastoral cooperative fund:

(i) The drug, medical treatment projects used do not include a directory of medical medicines for cooperation in new rural pastoral areas and a directory for the medical treatment project;

(ii) Medical costs should be borne by third parties;

(iii) The burden of public health should be borne by public health;

(iv) Medical care outside the country;

(v) Medical costs incurred as a result of deliberate crimes;

(vi) Medical costs incurred for non-fundamental medical needs, such as the United States of America and the whole;

(vii) No referral of relevant procedures to an integrated area of medical treatment, as required;

(viii) Other cases that are not reimbursed by the State and the self-government zones.

Chapter V

Article 42 states that the health administration should establish a targeted medical institution in accordance with the principles of medical treatment, the reasonableness, technical suitability and fairness.

Article 43 should have the following conditions:

(i) To obtain, in accordance with the law, a licence for the operation of the medical institutions;

(ii) The medical services provided are in line with the requirements for cooperation in new rural pastoral areas;

(iii) The fees for medical services are in compliance with the relevant provisions;

(iv) Provide the necessary dedicated or part-time staff and equipment for the settlement of medical costs.

(v) The hospitalHIS system works with a new rural pastoral health system.

The list of targeted medical institutions should be made available to society for two years.

Article 44 quateria shall enter into a new agreement on the provision of medical care in rural pastoral areas with targeted medical institutions to clarify rights obligations.

Article 44 15 Medical institutions shall perform the following duties:

(i) In a timely manner, medical treatment for new rural pastoral areas;

(ii) To verify the authenticity of medical treatment for patients in new rural pastoral areas;

(iii) Provision of health education, policy advice, treatment projects, etc. for new rural pastoral cooperative medical patients;

(iv) Implementation of the directory and the directory of the new rural pastoral project for the reimbursement of basic medicines issued by the Health Administration;

(v) Strict implementation of medical technical standards and operational norms developed by national and autonomous areas;

(vi) Excluding new types of rural pastoral cooperative projects and prices, reimbursement conditions and procedures, coverage of reimbursements, rates of reimbursement, etc.

(vii) Coherence with other regulatory provisions for cooperation in rural pastoral areas.

Article 46

(i) Include medical costs for non-participated persons in reimbursements for the new rural pastoral cooperative fund;

(ii) Include medical expenses to be borne by the participants in the new rural pastoral cooperation fund;

(iii) There is a need for inspection, medication and treatment beyond patients' morbidity;

(iv) Urgently raise the fee rate and increase the charges project;

(v) To identify new types of rural pastoral cooperative health funds;

(vi) Other violations of the medical provisions of new rural pastoral areas.

Chapter VI Safeguards and oversight

Article 47 Governments of more people at the flag district level should incorporate new types of rural pastoral cooperative medical work into annual work appraisal targets.

The Government of the people above the flag district should guarantee the basic conditions of service, staffing, operational requirements, etc. of the institution to adapt its functions and operations.

Article 49, the health administration should establish the criteria for the evaluation of the targeted medical institutions, implement credit ratings and publish the results of the evaluation to society.

Article 50 Audits, finances, inspection services should monitor the payments, management, etc. of the new rural pastoral cooperation fund and make the results available to society.

Article 50 states that price authorities should manage and monitor the prices of medicines and medical services for targeted medical institutions.

Article 52 should establish and publish new rural pastoral cooperative medical surveillance reports telephones and complaints kits to receive complaints and reports.

Article 53 should indicate, at least once a year, the mobilization and use of a new rural pastoral cooperation fund.

Chapter VII Legal responsibility

Article 54

(i) No payment for the benefit of the participant in accordance with the provisions;

(ii) No payment of contributions to the participant, as prescribed;

(iii) No transfer of the fees paid by the participant to the special house of the new rural pastoral cooperation fund, as required;

(iv) Constraint, misappropriation and appropriation of the expenses incurred by the participant;

(v) Other acts in violation of the provisions of the medical fund for cooperation in new rural pastoral areas.

Article 55 deceives a new facility for cooperation in rural pastoral areas, which is returned by a sensorship of the health administration, and double the amount of the tens of three times the proceeds of the conflict.

Article 56 of the new rural pastoral cooperative medical establishments and their staff have one of the following acts, which are being restructured by the sanitary administration, and fines of up to $300,000 for the targeted medical institutions, warning the direct responsible and other direct responsible personnel and fines up to 5,000 dollars for the direct responsible personnel;

(i) There is no justification for refusing to receive the hospitalization of participants;

(ii) Provide participants with inspection, treatment and pharmaceutical services that are not relevant to the disease;

(iii) Bring the costs of a new rural pastoral cooperative medical medicine reimbursement or a medical treatment project reimbursed for the personal burden of the owner;

(iv) To include in the reimbursable range of reimbursements for new rural pastoral areas for medical treatment or reimbursement for medical treatment projects;

(v) In the absence of the consent of the participant, the use of new rural pastoral cooperative medicines outside the directory of medical medicines or the implementation of the medical treatment project to reimburse outpatient medical treatment projects;

(vi) Limitation of the cost of hospitalization for participants;

(vii) The referral of a participant who does not meet the conditions of referral or is not in a timely manner in the process of referral for a participant who meets the conditions of referral;

(viii) Other forms of violation of the provisions of medical management for cooperation in new rural pastoral areas.

Article 57 of the new rural pastoral cooperative medical care institutions and their staff have one of the following acts, returned to the proceeds of the violation by a sensorship of the health administration and a fine of more than three times the proceeds of the violation, up to 3,000 dollars; and administrative disposition of the direct responsible and other persons directly responsible:

(i) Include medical costs for non-partisan participants in the reimbursement area;

(ii) Destruction, concealment and falsification of medical instruments;

(iii) Other offences.

Article 58 is one of the following acts by the Office of the High Commissioner and its staff, which is being converted by the time limit of the executive order of the health administration and administratively disposed of directly responsible supervisors and other direct responsibilities:

(i) Unregistered as a participant under the provisions;

(ii) Reimbursement of medical expenses for participants in the prescribed period;

(iii) Exhibit, misappropriation and appropriation of a new facility for cooperation in rural pastoral areas;

(iv) In violation of the new rural pastoral cooperative health-care system, resulting in losses of the Fund;

(v) Reimbursement of medical costs for cooperation in new rural pastoral areas in violation of the provisions;

(vi) Other offences.

Article 599 is disposed of by the health administration and the relevant departments and their staff toys negligence, abuse of authority, provocative fraud.

Article sixtieth violates the provisions of this approach and constitutes an offence punishable by law.

Chapter VIII

Article sixtieth of this approach is implemented effective 1 March 2013.