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Guangzhou, Guangzhou Municipal People's Government On The Revision Of The Decisions Of The Trial Procedures For Basic Medical Insurance For Urban Workers

Original Language Title: 广州市人民政府关于修改《广州市城镇职工基本医疗保险试行办法》的决定

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Decision of the Government of the Hiroshima to amend the pilot scheme for basic health insurance for urban workers in the city

(The 15th ordinary meeting of the People's Government of the Grand State of 14 May 2012 considered the adoption of the Decree No. 80 of 30 July 2012 on the date of publication of Government Order No. 80 of 30 July 2012)

At the 1415th Standing Conference of the Municipal Government, the following amendments were made to the Basic Health Insurance Scheme for Employers in the City:

Article sixtieth amends “....; delays in payment of contributions, with the date of unpaid contributions from the human resources and social security sector or the local tax sector, to receive five lags of lags on a day-to-day basis; the late refusal to pay medical insurance payments, lags, with a fine of up to three times the amount owed by the human resources and the social security sector or the local tax sector. The late denial of payment of health insurance payments, lagnesties, is governed by the human resources and social security sector or by the local tax sector.

This decision is implemented since the date of publication.

The Basic Health Insurance pilot scheme for Grace Town Employers was re-published in accordance with this decision.

Annex: A pilot approach to basic health insurance for urban workers in broad states (Amendments in 2012) (Act No. 11 of 30 July 2008), published in accordance with decision No. 80 of 30 July 2012.

Chapter I General

Article 1 establishes a basic health insurance system to guarantee basic medical care for workers in towns, which is based on the Labour Code of the People's Republic of China and the relevant provisions of the State and province.

Article 2 applies to enterprises within the city's administrative system, individual economic organizations, business units, State agencies, social groups, non-commercial units (hereinafter referred to as the user unit) and their in-service and retired workers (hereinafter referred to as security agents).

Article 3. Cross-regionally, more mobile user units and their employees should participate in basic health insurance in the integrated areas in a relatively concentrated manner.

Article IV. The level of basic health insurance should be tailored to the level of productivity development in the city and to the affordability of financial, user units and individuals; basic health insurance costs should be borne by both user units and workers; the combination of the basic health insurance funds in the social integration and personal medical accounts; and the progressive development of a multi-tier health-care system.

Article 5 The human resources and social security sectors at district, district level are responsible for the management and services of health insurance within the jurisdiction.

The Social Insurance Agency in the human resources and social security sector conducts specific health insurance services.

Ministries and organizations, such as finance, tax, price, sanitation, food medicine regulation, business, audit, civil affairs, education, trade unions, implement this approach in line with their respective responsibilities.

Chapter II

Article 6. The unit of the person shall, in accordance with the provisions of the human resources and social security sector, process the registration of basic health insurance by designated social insurance agencies. The newly established user units should be processed within 30 days of the establishment.

A person's unit shall terminate in accordance with the law or change in the registration of the basic health insurance, within 30 days of the date of the termination or modification, to the former registration body for the write-off or modification of registration procedures.

Article 7. In-service and user units shall pay their basic health insurance expenses in full by month.

The number of pay-for-service workers is the monthly average of personal income taxes, salary incomes, and the number of additional employees of the unit is the sum of personal income earned and salary incomes reported on by themselves in the month of social insurance. The average monthly salary of personal income, the average monthly salary income exceeds 30 per cent of the average monthly salary of employees of the previous municipal unit, which is not partly due to the payment base, 60 per cent below the average monthly salary of the employees of the previous municipal unit, and 60 per cent of the average monthly salary for the employees of the current municipal unit for the year. The number of contributions from the user unit is based on the contributions of the current unit's staff.

Individuals of active workers should pay basic medical insurance fees by 2 per cent of their contributions base, and the unit should pay basic medical insurance fees by 8 per cent of its contribution base.

Article 8. When the insured person conducts the retirement process, the actual annual period of payment for the basic health insurance (hereinafter referred to as the contributory period) is required for 10 years and the retired party has access to basic health insurance treatment. The contributory period is less than 10 years, and the transitional basic health insurance pension (after monthly calculation) should be paid on a one-time basis (hereinafter referred to as transitional payments); a one-time payment is difficult, with the approval of the municipal human resources and the social security sector. The payment rate for the Transitional Fund was 7.5 per cent of the average monthly salary for the last year's employees.

The user unit shall pay a lump sum at the time the insured person has not participated in the basic health insurance for the duration of his or her work, with less than one-time payment paid by him or her and received by the user unit.

The military service or the human resources and social security sector approves the redeployment of staff from the local administration area to the employees of the unit of the population, whose previous work is limited to the first-party unit of the re-entry, recognizes that the continuous calculation of the working age and pays a transitional fund in accordance with the preceding paragraph.

Article 9. When a person's unit is disbanded or terminated by a male worker of 50 years of age, a female employee of the age of 40 years who has reached the age of up to the date of dismissal or termination of the basic health insurance, the user's unit shall pay a one-time payment in accordance with the actual year of work of the unit to calculate the amount of contributions to the basic health insurance.

Article 10 The annual period for old-age insurance payments until 1 December 2001 (considered to be paid for the same period as for the old-age insurance, with the same time) reached 25 years, was fully funded by the Government's earmarked funds; 50 per cent had been paid by Government-specific funds in 20 years and 50 per cent had been paid by themselves; and in 20 years, its transition payments were paid by themselves.

In the case of retirement of the new unit, a person who has been employed at 50 years of age and after the unemployment of women who have reached the age of 40 years shall be financed by the specific funds established by the Government of the people at all levels.

Article 11. The basic health insurance fees and transitional payments to be paid by the user unit shall be charged in accordance with the provisions of the tax sector. The basic health insurance payments paid by the individual worker are deducted from the personal income tax.

Article 12 The Social Insurance Service is working in collaboration with the agencies.

Employers should pay basic health insurance fees, which are paid by the user's unit from their own salary in the month.

The basic health insurance payments and transitional payments made under the law are not returned.

Adjustments to the basic health insurance payment rate are made by the urban human resources and the social security sector with the financial sector, which is published by the Government of the city, with the approval of the provincial and municipal peoples' governments.

Article 14.

Article 15. The transfer, separation, consolidation, closure, insolvency shall be made in accordance with the law, and the payment of basic medical insurance payments, transitional payments, interest and lagging.

Chapter III Integrated Funds and Personal Medical Accounts

Article 16 provides for basic medical insurance payments paid by a person's unit and a worker, as well as for a transitional period of time, for which an integrated fund and a personal medical account has been established by the social insurance agencies, and cannot be accounted for separately.

Transitional payments made by a person's unit or by a person, as well as by earmarked funds established by all levels of the people's Government, are paid in accordance with the number of retirees who receive health insurance treatment in the month, and 75 per cent of the average monthly salary of 755 per cent of the employees of the above-year commune unit is used on a monthly basis.

Article 17 consists of the following:

(i) The basic health insurance payments paid by the user unit and the transitional payments made during the year, with the exception of the portion of the provision for the personal medical accounts.

(ii) The balance and interest of the Integrated Fund.

(iii) Flags charged as prescribed.

(iv) Government funding.

(v) Legal income.

Article 18

(i) The full payment of personal contributions to active workers.

(ii) The portion of the basic health insurance payments and transition payments paid from the user unit, as set out in article 19 of the scheme.

(iii) Legal income such as interest in the personal medical accounts.

Article 19

The proportion of the basic medical insurance payments paid by the user unit and the current transitional period is to be attributed to the personal medical accounts in the month:

(i) The age of 35 is 1 per cent.

(ii) Between 35 and 45 years of age.

(iii) The age of 45 years until retirement is 228 per cent.

(iv) The number of retirees is 51 per cent.

Article 20 The principals and interest in the personal medical accounts are used to cover basic medical costs, which may be transferred without cash or misappropriation.

After the death of the insured person, the balance of the individual medical account was transferred to the personal medical accounts of his successor; the successor did not participate in the basic health insurance; the balance of the personal medical accounts could be paid to the successor; and the balance of the individual medical account was included in the integrated health insurance fund.

Article 21 Rates of interest and interest in the end-of-year balance of the personal medical accounts are implemented in accordance with the relevant provisions of the State Department's Decision on the establishment of a basic health insurance system for urban workers.

The Social Insurance Agency and the relevant banks should facilitate access by the insured person to the income and expenditure of the individual medical accounts.

Chapter IV

Article 22 provides for the participation of a person's unit and his or her employee in the basic health insurance and the payment of his/her pay in full and on time, the insured person may receive the basic health insurance treatment in the month of the month. After the termination of the health insurance relationship, in the second month of the cessation of the payment, the basic health insurance treatment was discontinued, but the personal medical accounts balance could continue to be used.

In the absence of timely payment of medical insurance payments (hereinafter referred to as unpaid contributions) by the user unit and the insured person, the temporary absence of basic medical treatment by the insured person for the month of unpaid payment, interest and lag fund payments within three months may be paid to the medical expenses paid by the integrated fund, the cumulative payment of the insured person's contributions and the corresponding amount to be added to the personal medical accounts; and the payment of the outstanding contributions for the three-month period, the payment of interest and the payment of the medical insurance to the person concerned shall be charged with the payment of the medical expenses incurred.

Article 23 pays medical expenses for insured persons, which should be in line with basic medical coverage, the scope of medical treatment projects, the scope of medical services facilities and the payment standards and basic health insurance provisions.

The basic health insurance is available on the basis of national, provincial provisions.

The urban human resources and social security sector can adjust the proportion of payments made by the integrated fund for basic health insurance, therapeutic projects, medical services facilities, in accordance with the level of economic development and the actual situation, to be followed by the approval of the Government.

Article 24. The Integrated Fund pays more than the standard of payment, in proportion to the maximum number of inpatient hospitals, basic medical costs for specific projects and basic medical costs for the designation of chronic diseases.

The personal medical accounts cover the following basic medical costs:

(i) Dispatient general diseases and basic medical costs for emergency care.

(ii) In basic medical costs, such as inpatient hospitals, specific projects and the designation of chronic diseases, the costs of the individual should be borne.

(iii) Consistences are equipped with pharmacies or purchase non-conventional medicines.

(iv) Other costs under national, provincial health insurance policies.

Article 25 Specific projects for referral include the following:

(i) Treatment at the observation of the emergency medical clinic at the second and third levels.

(ii) Treatment of family beds at first, secondary-point medical institutions or targeted community health services.

(iii) Distinguished syllabus treatment, radiation treatment and support for medical treatment by designated targeted medical institutions, and the treatment of urtures by the designated targeted medical institutions.

(iv) Removal treatment of kidneys by designated targeted medical institutions continues to be carried out in the medical clinic of designated targeted medical institutions.

(v) The treatment of blood-related illnesses at the level of a three-tier medical facility.

(vi) Additional sickness or treatment projects pursuant to article 33 of this approach.

Article 26

(i) On-the-job workers: 500,000 medical institutions at the primary level; 1000 at the secondary medical facility; and Principal level medical institutions are 2,000.

(ii) Retirement: $350 at the level of medical institutions; $700 at the secondary level; and 31400 at the third level of medical institutions.

The designation of single-dose in the hospitalization of the insured person and the criteria for the start-up of the project are developed and published separately by the urban human resources and the social security sector, the financial sector.

Article 27 criteria for the start-up of basic medical costs for specific projects are determined according to the following criteria:

(i) The criteria for the observation of the Emergency Clinics are determined by the criteria for the inpatient hospitalization of the three-point medical facility, each of which is calculated for one year.

(ii) The payment rate for the family is determined by the criteria for the inpatient hospitalization of the insured person at the level of the medical facility at the primary level, and is calculated on 1 90 days.

(iii) Other gate-specific projects do not establish a standard for the payment of basic medical costs.

Article 28

(i) In-service workers: 90 per cent of hospitals; 85 per cent at secondary hospitals; and 80 per cent in tertiary hospitals.

(ii) Retirement: 93 per cent at the level of hospitals; 89,5 per cent at secondary hospitals; and 86 per cent at tertiary hospitals.

The Integrated Fund is determined by the proportion of hospitalization payments by the insured person at the level of the targeted medical institution.

In each year of social insurance, the Integrated Fund for Basic Health Insurance pays the hospitalization of the insured person, a specific patient project and the designation of the basic medical costs for chronic illnesses, with a cumulative maximum of four times the average annual wage for the employees of the previous occupancy units.

Article 33 of the Integrated Fund pays for the designation of single diseases or projects that occur inpatient hospitals, the scope, standards and approaches of specific projects and the designation of chronic diseases, which are developed separately by the urban human resources and the social security sector and made available to society.

The standard of payment and the proportion of the basic medical costs of the insured person inpatient care and for specific projects are adjusted by the urban human resources and the social security sector, with the financial sector, following the approval of the Government of the urban people, in accordance with the medical insurance balance.

In one of the following cases, the Medical Insurance Fund does not pay for medical expenses incurred by the insured person:

(i) suicide, maiming (other than mental illness);

(ii) Fighting, alcohol abuse, drug abuse and injury caused by crime or by law enforcement;

(iii) Transport accidents, accidental accidents, medical accidents, etc., are expressly subject to the liability of others for medical expenses;

(iv) The purchase of medicines and pharmacies without the approval of a non-settlement medical institution for medical treatment or for a non-settlementary retail shop;

(v) Treatment abroad or in Hong Kong, Macao Special Administrative Region and Taiwan;

(vi) Scope of work injury insurance or maternity insurance payments;

(vii) Non-payment under the relevant provisions.

Article 32, on medical expenses incurred by the insured person in connection with medical treatment or the purchase of medicines and the distribution of medicines in compliance with the basic health insurance requirements, is governed by the following provisions:

(i) Payments made by the Integrated Fund are made by targeted medical institutions or by customized retail pharmacies. Targeted medical institutions, customized retail stores, and settlement banks' medical expenses paid by the Integrated Fund for accounts and for medical expenses incurred from the personal medical accounts of the insured person are reported to the designated social insurance agencies on a monthly basis.

(ii) Payments made in the personal medical accounts, by targeted medical institutions or by customized retail pharmacies from the personal medical accounts of the insured person. The portion of the underpayment of personal medical accounts is paid by himself.

Article XIII provides medical treatment during the separation, separation or out of the country, as well as for public travel or visits, emergency medical treatment during the tourism period, and medical expenses incurred by local medical institutions are covered by the Integrated Fund of the city, which are reimbursed by the municipal social insurance agencies as prescribed.

The medical treatment is provided by the urban human resources and the social security sector.

Article XIV of the Social Insurance Agency shall address medical costs in accordance with the relevant standards established by the urban human resources and the social security sector in accordance with the following payments:

(i) The basic medical costs of the general (hosting) clinic and some of the specific projects are met in the form of service projects.

(ii) Basic medical costs for hospitalization for general illnesses, which are settled by an average of annual or beds or settled by service projects.

(iii) Designation of basic medical costs for chronic diseases and some of the specific projects to be met in a manner that combines service projects and the maximum monthly payment limits.

(iv) The basic medical costs of the family bed, which are settled on an average basis by the service project or by the beds (months).

(v) A portion of the medical costs of a disease or treatment project, which is settled by an average of the annual (month) or a cycle limit.

(vi) Other means of payment.

Chapter V

Article 35 Medical institutions and retail pharmacies with effective authorizations granted by the health sector or the food medicine control sector, as well as military medical institutions authorized by the military authorities to qualify for external services, may submit applications to the urban human resources and the social security sector for basic health insurance coverage services, which are validated by the urban human resources and the social security sector. In accordance with the qualification, after the signing of the basic health insurance service agreement with the Social Insurance Agency, it was determined to be a targeted medical institution, a targeted retail pharmacies, which were made public by the urban human resources and the social security sector.

Medical institutions with special illnesses, treatment subjects, basic medical services such as pharmacies or retail pharmacies are determined by the urban human resources and social security sector in the context of access to health insurance-dependent institutions, and supplementary agreements are concluded with the social insurance offices.

In accordance with the level of economic and social development, the savings of the health insurance fund, the adjustment of medical prices and the actual cost of medical services, the standard of settlement with medical institutions is adjusted in due course.

Article XVI provides for the purchase of medicines, pharmacies for the medical care or for the customary retail pharmacies, which are required to produce effective health insurance vouchers; all of the costs incurred in medical care, buying medicines and pharmacies prior to their presentation of an effective medical certificate are borne by the insured person.

The emergency clinic or the lack of awareness, such as compression, cannot be presented at the site, and the relevant formalities should be filled within 3 days of the entry. Families or other escorts should cooperate in the process of processing due to, inter alia, the invalence of insured persons.

Article 337 Medical establishments, customary retail pharmacies should strictly implement price policies and standards established by States, provinces, municipalities, implement the relevant provisions of the basic health insurance system, establish an internal management system adapted to basic health insurance management, designate institutions and necessary personnel responsible for specific work in the management of basic health insurance services and provide accurate information on medical and medical costs.

Article 338 The relevant sectors of the Government of the city strengthen the management of medical insurance services for targeted medical institutions and targeted retail pharmacies according to their respective duties.

Chapter VI

Article 39 of this city builds on the introduction of basic health insurance, establishes a major sickness medical subsidy system, introduces a civil service medical assistance scheme and work injury, maternity-care management approach, establish a supplementary health insurance system for urban workers, encourage the establishment of a mutual health insurance system for personnel units and individuals, participate in commercial health insurance, introduce social medical assistance to meet the multi-tier health-care security needs of the various medical consumption levels and the various economic affordability units and their employees.

Article 40 establishes a system of medical assistance for major diseases. The insured person participates in major medical benefits on the basis of participating in the basic health insurance.

The user unit shall pay a major sickness health grant at 026 per cent of the average monthly salary of the insured person for whom it belongs.

The Government's dedicated funds or participation in the payment of a transitional fund by a person's unit shall be financed by the Government's special funds or by the user's units, or shall receive major medical benefits for the corresponding year.

The unemployed persons who participated in the basic health insurance during the period of unemployment insurance entitlements should pay major sickness medical benefits in accordance with the prescribed criteria and be distributed from the paid unemployment insurance. However, the unemployed clearly indicated that they did not agree with the exception of the surrender.

Article 40. Basic medical expenses incurred by the insured person, which are paid by major sickness benefits, after the year's accumulated excess of the maximum payment threshold for the integrated health insurance fund:

(i) Basic medical costs for inpatient and induction projects, which are paid by 95 per cent of the major sickness medical benefits.

(ii) Designation of basic medical costs for chronic illnesses, to be paid by the major sickness medical grant in accordance with the applicable standards.

During a social insurance year, the major sickness health grant paid a cumulative maximum of 150,000 dollars for the hospitalization of the insured person and for the basic medical costs for specific projects.

The supplementary health insurance payments to be paid by retired persons participating in the basic health insurance are paid from major sickness medical benefits.

The rates and treatment criteria for major sickness benefits, the scale-of-payments adjustments are presented by the urban human resources and the social security sector in conjunction with the financial sector in accordance with the payments balances of the health insurance fund and reported to the Government of the city.

Article 42 establishes a supplementary health insurance system for urban workers. The user units and their in-service workers may participate in supplementary health insurance based on their participation in basic health insurance and major sickness medical benefits.

Enterprises and other economic organizations may also establish complementary health insurance systems on their own, and the enterprise's supplementary health insurance scheme should be reported on urban human resources and social security sector reserves.

The total annual salary of enterprises or self-contributors for the payment of additional health insurance fees and the establishment of a supplementary health insurance system for themselves is 4 per cent of the total annual salary in this unit, which is covered by financial regulations, and the supplementary health insurance requirements for the financial nuclear service units are 4 per cent of the total annual salary in this unit and are shown in the cost of social security for expenditures or operating expenses. Financial treatment is inconsistent with tax provisions, and tax adjustments are treated in the calculation of enterprise income taxes.

Other user units complement the provision of health insurance by reference to implementation.

Article 43 develops and improves the social health care system in the city, and the authorities should take measures to mobilize funds to address the health problems of the urban poor.

Persons who meet the minimum standard of living for the families of the city's towns, who have no means of life, who have no labour capacity, are unable to provide support, support or statutory support, dependants have no maintenance, depending capacity, as well as privileged individuals, receive appropriate medical assistance and medical assistance, in accordance with the relevant provisions of national, provincial and municipal medical guarantees, and medical funding is addressed by the appropriate channels.

Article 44 states that after taking part in the basic health insurance, responsibility and obligations for health care other than basic health insurance such as medical insurance for workers, women workers' health, public health prevention, labour protection, family insurance should continue.

Article 42 occupants have been overburdened by the burden of treating individuals for illness, and the user units should help resolve through other safeguards.

Regulation and supervision of health insurance funds

Article 46 Human resources and the social security sector are responsible for the implementation of the laws, regulations and related provisions of the health insurance; the organization of the health insurance system; the study of policies, development planning and related standards for the development of health insurance; the supervision of medical insurance payments prepared by social insurance agencies; the supervision of payment of medical insurance payments and medical insurance payments; the supervision of inspection of medical institutions, the implementation of basic health insurance provisions by the targeted retail store.

Article 47 assumes the following responsibilities by the Social Insurance Agency:

(i) Social insurance services such as basic health insurance in the city's town and various supplementary health insurance.

(ii) Payment, management and inspection of health insurance payments.

(iii) The preparation of medical insurance advances, accounts, and the payment of health insurance costs.

(iv) Establishment and management of a personal medical account for basic health insurance.

(v) A health insurance service agreement with targeted medical institutions and a terminal retail pharmacies.

(vi) To assist the human resources and social security sector in providing guidance, supervision, inspection and evaluation on the implementation of basic health insurance policies, regulations and service agreements for targeted medical institutions, targeted retail pharmacies and service agreements, and to address the poor or default, non-compliance with medical institutions, in accordance with the agreement on health insurance-related provisions and service agreements.

(vii) Provide regular social information on the incidence of medical and pharmaceutical costs incurred by insured persons in targeted medical institutions, targeted retail pharmacies.

(viii) Statistical analysis of the payments of health insurance and the medical costs of the insured person.

(ix) Provide health insurance access, counselling services to user units and insured persons.

(x) Other responsibilities under national, provincial and present municipalities.

Article 48 provides for the harmonization, harmonization and harmonization of the use of health insurance funds.

The Medical Insurance Fund is included in the financial specialties of the Social Security Fund, accounting for accounts, the introduction of two income-of-payment lines management, specialization, no unit or individual may be excluded.

The requirements of the social insurance agencies are addressed by the financial budget and cannot be drawn from the health insurance fund.

Article 49 Bank accounts for health insurance payments are carried out in accordance with the provisions of the medical insurance fund.

Article 50 of the financial sector is responsible for the development and monitoring of the financial accounting management system relating to health insurance, which is responsible for the accounting of funds earmarked for health insurance and for the review of advances, accounts prepared by the social insurance agencies, and for the timely allocation of funds required for the payment of the health insurance payments accounts and for the funds required by the social insurance agencies.

Article 50 states that the audit department conducts an audit supervision of the receipt, payment, balance and the financial specialization of the Social Security Fund.

Other provisions of Chapter VIII

Article 52 establishes a basic health insurance system for urban residents. The basic health insurance coverage of the urban population is not included in the basic health insurance coverage of minors, non-inhabited urban residents and those who meet the age of retirement set by the State.

Article 53 deals with specific schemes such as basic health insurance for urban residents, health insurance for non-resident urban dwellers, supplementary health insurance, civil service medical assistance and higher colleges, secondary vocational schools, medical guarantees for full-time students in the technician schools, targeted medical institutions and customized retail shop management, and medical expenses and related standards, which are jointly developed by the urban human resources and social security sector with the relevant departments and are reported to be implemented after the approval of the Government.

Article 54, which has the origin of the city's towns, is 60 years of age for males and 55 years of age, is not able to receive a basic pension in the month, or a person who has been paying a pension for the basic health insurance of the urban workers for a period of 10 years, enjoys the basic health insurance treatment of retired persons; less than 10 years, a one-time payment of the basic health insurance benefits for retired persons is payable, in accordance with the standards set out in this scheme.

Article 55 provides for persons who are free to participate in health insurance as provided for in the relevant provisions of the present city, with the origin of the city's town, in accordance with the basic old-age insurance for the insured age, or in the form of part-time, temporary or flexible work, as well as unemployed persons who have not paid unemployment insurance payments in the month.

Article 56 provides practitioners of non-residents who work with the user's unit, who may be selected by a user unit to participate in the health insurance by means of this approach or by a medical insurance scheme for non-resident urban dwellers.

Article 57 manages the health insurance services associated with the payment of a lump sum and a major sickness grant by a socialized management service provider of the home area to assist the social insurance agencies.

The medical treatment of the dispersed and the old-age army is unchanged, and the medical costs are addressed by the source of funds.

Article 59, which causes the cost of medical care for acute, endangered, severe and traumatized patients, owing to factors such as epidemic, natural disasters and emergencies, is addressed in coordination with the Government of the city.

Chapter IX Legal responsibility

Article 63/, in violation of the relevant financial, accounting, statistical laws, administrative regulations and national provisions, the falsification, conversion, intentional destruction of the relevant books, materials or unaccounted for, prevents the medical insurance base from being determined in accordance with the State Department's provisional regulations for social insurance contributions; delays in the payment of contributions from the human resources and social security sector or the tax sector from the date of unpaid contributions; the failure to pay the medical insurance, the lagment and the amount of human resources paid to the social security sector for a period of three years. The late denial of payment of health insurance payments, lagnesties, is enforced by the human resources and social security sector or by the local tax sector.

Article 61 does not provide for the registration, modification or write-off of the medical insurance, or for the undeclared amount of the medical insurance premiums to be paid in accordance with the provisions, which is modified by the time limit of the human resources and the social security sector; in the case of serious circumstances, a fine of up to 5,000 dollars may be paid to the competent and directly responsible personnel directly responsible for them; in exceptional circumstances, a fine of more than 5,000 dollars for the direct responsible and direct responsibilities.

Article 62 does not provide for the payment of medical insurance expenses from the employee's salary, or for the release of medical insurance payments to the employee, as prescribed, by the human resources and social security sector or the tax sector, as well as a fine of up to 1000 dollars.

Article 63 refers to medical insurance payments by social insurance agencies responsible for recovery; serious circumstances, which do not constitute a crime, to be dealt with by public security authorities in accordance with the Law on the Safety and Security of the People's Republic of China; and to the transfer of criminal justice to the judiciary.

Article 63 quantified medical institutions have one of the following acts, which have been recovered by social insurance agencies by warnings from the human resources and social security sectors, and a fine of up to 00 million dollars. The heads of their institutions, the competent persons directly responsible and the person directly responsible may be fined by more than 200 million dollars; the circumstances constitute a serious offence and transferred to the judiciary to be criminalized by law:

(i) Medical costs for persons not participating in the health insurance are paid by the Integrated Fund for Health Insurance;

(ii) The medical costs to be paid by the medical insurance fund to be borne by individuals;

(iii) Inpatient treatment will be arranged for patients who do not meet the existing standards of hospitalization; or forfeiture of the hospitalization, sub-patient hospitalization; or intentional extension of the patient's hospitalization; or placement of persons not in compliance with the standards of the board; or

(iv) The transfer of medical expenses incurred by the Integrated Fund for Basic Health Insurance to individuals paid by the insured person;

(v) The transfer of medical costs that are not covered by basic health insurance payments to health insurance funds;

(vi) Access to health insurance funds without due means.

Acts prohibited by the previous paragraph are serious or uncorrected, and the human resources and social security sector should remove the qualifications of its targeted medical institutions.

Article 65 contains one of the following acts in the pharmacies, which have been recovered by the social insurance agencies and warned by the human resources and social security sector; at the same time, a fine of up to €300,000; a fine of up to $50 million for pharmacies, direct supervisors and direct responsibilities that can be fined to the head of the pharmacies, and which constitutes a serious offence and transferred to the judiciary to be criminalized by law:

(i) Non-subject to prescription drugs and dose-in-charge medicines;

(ii) Costs that would not fall within the scope of payment of basic health insurance are to be paid by the medical insurance fund or by the personal medical accounts of the insured person;

(iii) Transfer of prescription drugs into other medicines, goods;

(iv) Violations of basic health insurance management provisions.

The circumstances prohibited by the previous paragraph are serious or improvised, and the human resources and social security sector should remove the qualifications of its targeted retail pharmacies.

Article XVI of the Social Insurance Agency and its staff have one of the following acts, which are being restructured by human resources and social security sector orders, and are subject to administrative disposition by the competent and direct responsible person responsible for direct responsibility by the human resources and social security sector or by the supervisory authority; the transfer of criminal responsibility to the judiciary; the loss of health insurance funds, and the responsibility for recovery by the human resources and social security sector or local tax authorities:

(i) The cost of medical insurance to be paid by the user unit and the active worker;

(ii) The loss of health insurance benefits, in accordance with the regulations governing the examination of the unit of the agent, the contribution base for the employee and the violation of the health insurance scheme;

(iii) Removal of basic health insurance treatment or relaxation of the payment criteria.

There are other laws, regulations and regulations prohibiting acts, which are governed by law or criminal responsibility.

Article 67 Human resources and the social security sector and its staff do not perform supervisory duties under this approach or abuse of authority, provocative fraud, play negligence, and are subject to administrative disposition by law to their heads of departments, direct supervisors and direct responsibilities; and the transfer of criminal responsibility to the judiciary.

Article 68, Financial, levies, hygienic, food medicine regulation, price, audit, business, civil affairs, education and other departments and their staff do not perform the corresponding duties under this approach or abuse of their functions, invoking corruption, intrusive misconduct, and injuring their duties, shall be subject to administrative disposition by their heads of departments, competent persons directly responsible and persons directly responsible.

Article 69 staff in the human resources and social security sector or in the local tax sector are treated in accordance with the relevant provisions of the State Department's provisional regulations on social insurance contributions.

Chapter X

The medical insurance payments referred to in this scheme include the Basic Medical Insurance Fund, the Transitional Fund, the major sickness medical benefits, supplementary health insurance payments, civil service medical benefits.

The social witness pension referred to in this approach refers to the participation in social old-age insurance, the achievement of a mandatory retirement age, in accordance with the retirement conditions, and the introduction of retired social personnel to the human resources and the social security sector.

The socialization management of retirees referred to in this approach refers to the participation in social old-age insurance and, in accordance with the required procedures, to receive retirees administered by district, district-level pensioner administrations.

The basic medical costs referred to in this approach refer to the cost of medicines, medical treatment and medical services that fall within the scope of the basic health insurance, but do not include the cost of self-payment by the individual.

The year of social security referred to in this scheme is from 1 July to 30 June each year.

Article 76 of the Basic Health Insurance System for Urban Workers in the Administrative Region of the city is integrated and implemented on a step-by-step basis.

Prior to the introduction of an integrated municipal level, the area of chewing and district-level municipalities, and the industries that are not yet integrated in the management of the city, which, with the approval of the Government, can establish a basic health insurance system for urban workers in accordance with the principles of harmonization, independence and self-management. Adjustments to their health insurance schemes and treatment standards should be reported upon by the Government of the city.

The insured person's transfer of health insurance relations within the city's administrative area, mutual recognition of the length of payment for basic health insurance, the transfer of the insured person in connection with the health insurance, and the transfer of the transitional pay due to be paid at the time of retirement.

Article 72