Key Benefits:
(Act No. 180 of 30 January 2008 of the People's Government Order No. 180, dated 1 March 2008) Chapter I General Article 1 provides for the establishment of a social health insurance system in Shenzhen and enhances the ability of the insured person to respond to the risk of disease and to ensure their medical needs, and, in accordance with the relevant provisions of the State, develops this approach in conjunction with the current city. Article 2 The Government has established basic health insurance, local supplemental health insurance and maternity insurance systems. The basic health insurance includes four forms of health insurance, inpatient health insurance, inpatient health insurance for farmers, inpatient care for juvenile children and inpatient health insurance. The Government has established a civil service medical subsidy system to encourage and support the establishment of an enterprise supplemental health insurance system to encourage individuals to participate in commercial health insurance. Article 3. All persons in the city and their employees and other persons of the city shall participate in the health insurance as provided in the scheme. This approach refers to the authorities, business units, social groups, businesses, non-commercial units and individual economic organizations of the city's administration. This approach refers to the user units already involved in health insurance. This approach refers to persons already involved in health insurance. This approach refers to rural household employees who are employed in non-residents in the city. Article IV. The health insurance system should be guided by the principles of equity and efficiency, relative rights and obligations, and the level of safeguards adapted to the level of social productivity development. Article 5 Relevant sectors such as urban rehabilitation, education, civil affairs, finance, health, prices and drug management should assist in the health insurance process. Article 6. The ISA Oversight Committee is responsible for monitoring the implementation of health insurance laws, regulations, regulations and payments, use, management. Article 7. Municipal governments may adapt to the payment standards, the proportion of funds and individual accounts, and the treatment, in accordance with the payment of health insurance costs. Chapter II Article 8 (i) In-service staff with the home; (ii) Prior to retirement, a resident of the city, and the municipal social insurance agency pays a pension for old-age insurance treatment by month; (iii) To participate in the integrated presence of the old-age insurance industry, which is paid by the Semitic Province, the Social Insurance Agency in Beijing in monthly insurance entitlements, and to retired persons who participated in my municipal health insurance prior to retirement; (iv) Until the mandatory retirement age, a resident of the city has no pension receiving the old-age pension; (v) Persons who have no medical safeguards in other parts of the country following the mandatory retirement age; (vi) Persons who have the origin of the city, who have not attained the mandatory retirement age for the age of 18 years, have not been enrolled in schools, without access to unemployment insurance treatment or minimum living guarantees, and who have no personal unit; (vii) Other personnel provided by the municipality. Persons are encouraged to participate in the integrated health insurance for their non-resident employees. Article 9 (i) In-householding personnel from non-resident city households; (ii) Retirement of non-residents who are paid by municipal social insurance agencies for the treatment of old-age insurance by month; (iii) Persons with the residence of the city who receive unemployment benefits; (iv) Persons with whom the city is home, who are above the age of 18 years and enjoy the minimum living guarantees; (v) Establish farmer labour-related workers with other units other than the city; (vi) Other personnel provided by the municipality. Those who do not have a statutory retirement age may apply for participation in hospital health insurance. Enterprises are encouraged to participate in hospital health insurance for their farmers. Article 10. Farmers' work health insurance is applicable to the work of peasants working with this city's enterprises. Upon application of the enterprise, the incumbents of the low-income non-resident city households can participate in the farmer work health insurance. Article 11. The inpatient and high-patient health insurance for juvenile children is applicable to the institution of nursery, primary, secondary, high schools, special schools, technics and children who have been under 18 years of age, approved by the Ministry of Education, Civil Affairs, Labour Security, etc., as well as juvenile children who have been under 18 years of age, who have no access to school. Article 12 Article 13. Reproductive health insurance applies to persons who have not attained the mandatory retirement age in integrated health insurance. Article 14. Chapter III Fund mobilization and management The Medical Insurance Fund includes the Basic Health Insurance Fund, the Local Supplementary Health Insurance Fund and the Reproductive Health Insurance Fund. The basic health insurance fund consists of the Integrated Fund and the Personal Account, which consists of the Integrated Disease Fund, the Community Mapping Fund and the Fund. Article 16 of the Medical Insurance Fund is fully integrated into the financial specialties of the Fund, with the introduction of two income and expenditure line management, with a specific provision and a strict ban on diversion. The Health Insurance Fund is implementing the principle of payment, balance of payments and savings. The health insurance fund is subject to financial subsidies when special circumstances such as the outbreak of disease and severe natural disasters are not used. The financial response to the provision of adequate subsidies for the participation of households in the health insurance for non-farm and peasant workers in the city, with the specific approach being developed. Article 18 (i) Medical insurance fees paid by the participating units and the insured person; (ii) Interest in health insurance fees; (iii) Financial subsidies; (iv) Other income. Article 19 (i) On the basis of the total monthly salary of the staff member, 8 per cent of the paid base was paid in the month, 6 per cent of the total monthly wage was paid by the person's unit and 2 per cent paid by the individual, which exceeds 30 per cent of the average monthly salary of the insured employee in the current city, 30 per cent of the average monthly salary paid to the employee in the current city and 60 per cent of the average monthly salary for the current year; (ii) Previous retirements are made up of homeowners, who are paid by municipal social insurance agencies for old-age pension treatment by month, with a monthly basic pension pay base of 11.5 per cent of the old insurance fund's contribution base; (iii) To participate in the integrated presence of the former old-age insurance industry, which is paid by the Hiroshima Province, the Social Insurance Agency in Beijing in the month of the old-age insurance scheme, and to receive a lump sum of 12.5 per cent of the annual average monthly salary of the occupants in the current city, by the former agent's unit at the pay base of 1.5 per cent; (iv) The number of retired persons who had been granted old-age insurance treatment prior to the mandatory retirement age and the amount of payment was chosen between 60 per cent and 30 per cent of the average monthly salary of the insured employee in the current city, and was paid by 15.5 per cent of the salary paid base. (v) Persons who have no social medical security after the retirement age of the statutory retirement age and who are not entitled to social health care elsewhere in the country, who are personally at the first time participating in the health insurance in this city, paying the average monthly salary of the employee in the current city for the first year, 1.5% of the contributory base x 12 months x 18 years; (vi) Withholding home, the age of 18 years has not reached the statutory retirement age, which has not been enrolled in schools, is not entitled to unemployment insurance treatment or minimum living guarantees, and the number of persons who do not have a personal unit, is chosen between 60 per cent and 30 per cent of the average monthly salary of the insured employee in this city and surrendered by 8 per cent of the paid base; (vii) Other personnel are executed in accordance with the relevant provisions of the municipal government. Article 20 (i) On-the-jobed personnel were surrendered by 0.6 per cent of the contributions base, and individuals were paid by 0.2 per cent of the contributions base; (ii) Retirement of non-residents who are paid by municipal social insurance agencies for the treatment of old-age insurance by month, as well as those who have been unemployed during the payment of unemployment benefits, are paid by the municipal social insurance agencies and are charged separately from the basic old-age insurance funds and the unemployment insurance fund; (iii) Revenue channels for other personnel are provided separately. Article 21 Supplementary health insurance payments are paid according to the following criteria: (i) Participation in integrated health insurance personnel, which is paid at 0.5 per cent of their contribution base; (ii) Persons participating in the hospital health insurance are paid by 0.2 per cent of their contributions base. In-service staff are paid by the user unit and other personnel are executed on the basis of their contributions and contributions to the basic medical insurance payments. Article 2 Article 23.5 per cent of the maternity health insurance rate, which was paid on the basis of the combined medical insurance fee, was paid in the month, and the active staff were paid by the user unit and others were paid by themselves. Article 24 provides that a person's unit shall, within 30 days of the establishment or acquisition of a business licence, be registered and involved in the social insurance institution. The homeowner of the non-exclusive unit is represented by the person in the social insurance institution. The medical insurance fee is transferred to the Social Insurance Fund accounts established by the municipal social insurance agencies after the receipt of the month's visit by the occupants of the insured unit or the insured person. Article 25 The occupants of the city may continue to pay for their health insurance payments due to changes in their work. Participation in the basic health insurance in the city for more than one year, with the result of changes in work, may be consolidated for the duration of the year after the repayment of the year after which it was suspended. During the health insurance year, the time limit for recalculation was calculated for more than three months. Article 26 may choose to participate in the form of health insurance, but no change shall be made within 12 months of the choice of participation. The insured person re-elected the form of health insurance, and it participates in basic health insurance coverage periods during different forms of health insurance may be converted to each other. Consolidation of health insurance and inpatient health insurance coverage for insured persons may be converted to each other. The number of years of insurance for former workers is considered to be the same as the number of years of insurance for farmers. Article 27 pays medical insurance fees paid by a person's unit and a person prior to the taxation. Article 28 The basic health insurance fees paid by the insured units and the insured person enter the basic health insurance fund to cover the treatment of basic health insurance; local supplemental health insurance fees to local supplement health insurance funds to cover other expenditure projects under the local health insurance treatment and this scheme; and access to the maternity health insurance fund to cover the treatment of maternity health insurance. Article 33 Social Insurance institutions establish personal accounts for integrated health insurance workers, mainly for medical treatment costs, with a specific proportion of: (i) Unemployed persons, 5 per cent of persons under 45 years of age who are under the payment base are added to the personal accounts, and 5.6 per cent of persons over 45 years of age are accounted for in the personal accounts; (ii) In the case of the insured person, 8.0 per cent of the contributions base is accounted for in the personal accounts. Of these, a one-time payment of health insurance expenses shall be charged to the individual accounts for the monthly accounts and the monthly payment period of the continuing payment period from 1 month of the surrender. The remaining portion of the basic health insurance fee for the integrated health insurance has entered the Integrated Fund for Diseases, mainly for medical expenses under this scheme. Article 31 provides for the establishment of community-based referral funds and consortiums for inpatient health insurance and for farmers' health insurance participants, from the health insurance fees of each insured person to the community gate fund in which the Social Insurance Centre is selected to meet the medical costs of the medical treatment; and the transfer of a dollar as a facilitator to select the Social Consequency Centre to cover medical costs. Inpatient health insurance and basic health insurance fees for farmers, the remaining portions other than access to the Integrated Fund for Community Uppatients and Emergency Relief Funds entered the Fund. The Integrated Community Mapping Fund has a balance to be used for the next year. Article 32 Participating in the death of the insured person, whose personal accounts balances were paid to the successor; they were not succeeded and transferred to the Integrated Fund for Basic Health Insurance. A lump-sum payment for medical insurance was killed and the medical insurance payments paid were not transferred to the Integrated Fund for Basic Health Insurance. Chapter IV The insured person enjoys medical insurance treatment under this scheme effective 1 of the first month after the payment of medical insurance expenses in full. The insured person ceases to enjoy the medical treatment paid by the Integrated Health Insurance Fund but may continue to use its personal accounts balance as of 1 January that the insured person has not paid or interrupted the payment of the medical insurance payment. Article 34 of the Basic Medical Insurance Insecutors enjoy basic health insurance treatment within the criteria for the collection of essential health insurance medicines, therapeutic projects and medical facilities. Local supplemental health insurance workers can benefit from the health insurance treatment provided for in this scheme. The child health insurance insured person may enjoy the treatment of maternity health insurance under this scheme. Article XV of the Basic Health Insurance Medicine, the Basic Health Insurance Meditherapy project, a directory of the basic medical facility is carried out in accordance with the directory published by the State and the Ministry of Labour Guarantee in the wider province. The coverage of local supplemental health insurance medicines and medical treatment projects, the scope of special medical material and manual organs, the scope of the large medical equipment inspection and treatment projects are implemented by the municipal labour security sector in conjunction with the urban health sector. Special medical material, the scope of manual organs and the maximum payment thresholds included in the integrated fund for basic health insurance are implemented in accordance with the scope and maximum payment limits issued by the municipal labour security sector. Article 36 The accumulated personal accounts amounted to an average monthly salary of the insured worker in the first month of the city, with more than partial coverage of the basic medical costs paid by the targeted medical institution, local supplemental medical costs, or non-participatory medical costs for the purchase of the basic medical health insurance directory and local supplementation of the medical health insurance medicine catalogue, which could also be used to cover medical expenses for health medical care for children who have been inpatient care and receive medical care. With the completion of the personal accounts of the insured person, it incurred medical expenses incurred in connection with the medical treatment, the Integrated Fund for Basic Health Insurance and the Local Supplementary Health Insurance Fund are not paid, except as provided for in articles 38, 39, 40 and 40. Article 338 Integral Medical Insurance Intakers incurred at the PSDC Centre in this city, meet the cost of medical treatment that is in line with the directory of basic health insurance medicines and the local supplementation of medical insurance medicines, 70 per cent are paid by personal accounts, and 30 per cent are covered separately in the coverage of the Integrated Fund for Basic Health Insurance and are paid by local supplemental health insurance funds. In accordance with article 39 of the Integrated Health Insurance Insurance Insurer's approval by customary medical institutions agreed by the municipal social insurance agencies, 80 per cent of the expenses incurred in the inspection and treatment of large medical equipment in the MTS are covered by the Integrated Fund for Basic Medical Insurance. The large-scale medical equipment inspection and treatment project management approach was developed separately by the municipal labour security sector. Article 40 On the basis of anaemia that is needed by the insured person, 90 per cent of the integrated health insurance insured person is covered by the Integrated Fund for the Basic Medical Insurance, 70 per cent of the inpatient health insurance and the farmers' health insurance are covered by the Integrated Fund. Article 40, paragraph 1, of the comprehensive health insurance attendance scheme provides for other medical treatments other than those provided for in article 40, paragraph 1, of the scheme, basic medical expenses incurred and the cost of supplementary medical insurance medicines, medical treatment projects that are covered by the individual accounts; corresponding medical costs incurred by the medical clinic, under-payment of personal accounts and more than 5 per cent of the average annual salary of the insured worker in the health insurance year, and more than 70 per cent of the basic health insurance funds are covered or funded by local health insurance funds. The former medical clinic is provided by the municipal labour security sector. In accordance with article 42, inpatient health insurance, the participation of farmers in health insurance units, and inpatient health insurance for unused units, the participation of farmers in the health insurance system should be based on the selection of a commune in the city for medical care. The cost of the hospitalization health insurance, the participation of farmers in the health insurance scheme is addressed in the following provisions: (i) A combination of medicines and b types of medicines in the basic health insurance medicine catalogues, which are paid by the Integrated Community Mapping Fund at 80 per cent and 60 per cent, respectively; (ii) A single price of up to 120 dollars for the medical treatment project or medical material in the basic health insurance directory, which is paid by the Integrated Community Medical Fund for 90 per cent; a single price of more than 120 dollars is paid by the Community Medical Integration Fund; (iii) In the case of illness, the insured person is required to receive referrals from the settlement hospitals to the medical expenses incurred by other targeted medical institutions, or emergency medical expenses incurred in non-retrocation hospitals, which are reimbursed by 90 per cent of the fees paid by the Integrated Community Medical Fund in accordance with paragraphs 1 and 2 of this article. The Integrated Community Mapping Fund pays to each inpatient medical care (including emergency) for each inpatient health insurance in a health insurance year, up to $80 million. Article 444 Rates of inpatient medicines incurred by the insured person are covered by the basic health insurance medicine directory, with the participation of retirees at 95 per cent and 90 per cent by other personnel in the integrated health insurance fund. The basic medical costs incurred by the insured person are covered by the medical treatment project and general medical material in the basic health insurance directory, with the participation of retirees at 95 per cent and 90 per cent by other personnel in the integrated health insurance fund. In the case of hospitalization of the insured person, special medical material is required for the basic health insurance treatment project, installation or replacement of a manual organ, one-time medical material using a single price of more than 1,000 dollars, which includes 90 per cent of the basic health insurance coverage at 90 per cent of the country's patrioritization price; non-country production is comparable to the price, and 60 per cent of the imported universal price is covered by the Integrated Fund. In the area of integrated health insurance, inpatient health insurance is up to a maximum of 50 yen/day, the maximum cost of the farmer workers' health insurance is up to $35/day. Article 42 establishes a different rate of inpatient care at different levels of the hospital, at the intra-municipal level and at the following hospitals, at 100 kidnapped at 2nd hospitals in the city, at 300 in the city's three-tier hospitals and at the non-resident hospital at $400. Inpatient medical costs, which fall under the umbrella of the Integrated Fund for Basic Health Insurance, are not paid. In-patient referrals to various hospitals, the custodian is counting on the rate of hospitalization. Article 46 provides the maximum payment limit for each year's basic health insurance fund to be linked to the length of the insured person's continuing participation in the basic health insurance, which is less than five times, one, two, three or four times the average salary of the employee in the current city for the previous year. Article 47 includes medical costs for the inclusion of medical care inpatient health insurance, inpatient health insurance inpatient care, which are paid in full by the Integrated Fund for the Basic Medical Insurance. Inpatient health care costs for farmers' health insurance workers are included in the coverage of basic health insurance accounts, in the number of inpatient care lines above, the highest payment thresholds for the Integrated Fund are paid by the Royal Medical Insurance Fund at the level of hospitalization, the proportion of payments for hospitals at the municipal level, secondary hospitals, three hospitals, outpatient hospitals, and outpatient hospitals is 95 per cent, 90 per cent, 80 per cent, 70 per cent, respectively, and the remainder are paid by the insured person. Farmers' health insurance workers are paid by 90 per cent of the expenses incurred in hospitalization for emergency medical care in non-retroactive hospitals, as prescribed by the previous standard, and are paid by conditional medical institutions. Article 48 retirees participating in the integrated health insurance can receive a one-time supplementary medical insurance pension grant of $500, which is subject to a monthly local supplementary health insurance grant of 20 dollars, to be added by the municipal social insurance agencies to their personal accounts from the local supplemental health insurance fund. Article 49 of the maximum payment limit for each year of health insurance supplements the medical insurance fund to the extent that the insured person has continuously participated in the local supplemental health insurance period, with the end of the period of up to one year, up from two years to three years, with a maximum payment limit of $50,000, 10,000 yen, 150,000, 200,000 dollars, leaving the maximum payment limit for more than six years. The local supplemental health insurance coverage is calculated prior to the implementation of this scheme. Article 50 supplements the costs incurred by the local health insurance insured persons, which are paid by 90 per cent of the local supplementary health insurance fund within the maximum annual payment limit for the local supplementary health insurance fund: (i) Include the scope of the accounts of the Integrated Fund for Basic Health Insurance and exceed the cost of the maximum payment threshold for the Integrated Fund for Basic Health Insurance; (ii) Costs for the use of local supplemental health insurance medicines and local supplemental medical treatment projects during the hospital period. Article 50 occupants participating in maternity health insurance are in line with family planning policies, with prenatal inspections, inpatient delivery, post-natal visits, basic medical costs for family planning operations (excluding infant costs) paid by the Reproductive Health Insurance Fund, which is specifically developed by the municipal labour security sector. Article 52 is in compliance with the standards of the institution, the school should be left out without the institution, and the medical insurance fund for its hospitalization expenses should not be paid from the date of the institution. Article 53 (i) In addition to article 36, paragraph 2, of this approach, the acquisition of medicines by themselves; (ii) Damage caused by work injury and responsibility of others; (iii) Damage caused by intentional acts or offences committed by themselves; (iv) Damage caused by traffic accidents and medical accidents; (v) Self-governance to foreign, port, Macao, ward; (vi) Other cases provided by the State, the Province of Broad East and the city. Chapter V Article 54 provides medical care for the integrated health insurance insured person in the city. Inpatient health insurance coverage should be medically available at the selected centre, and inpatient hospitals and high-patient illnesses should be medically available in the municipality. Farmers' health insurance coverage should be medically available at the selected centre of the community's consortia, or medical treatment with the selected centre and other customised associations that are part of a settlement hospital; emergency care may be available to the entrenched medical institutions in the city; inpatient hospitalization needs should be treated at the disposal centre's settlement hospitals; in the event of the referral process, other medical agencies are also available. Article 55 of the Integrated Health Insurance, Inpatient Health Insurance, Social Insurance, Designated by the Social Insurance Agency of the Inpatient Medical Insurance Agency to the city's out-of-the-clinical medical institutions, shall be subject to medical briefings by the municipal social insurance agencies designated by the municipal social insurance agencies. Article 56 provides one of the following cases in the treatment of medical institutions at the entry point: (i) The types of referral diseases published by the municipal labour security sector; (ii) Discussed illnesses that are still unspecified at the level of hospitals at the third level of the city or at the municipal hospitals; (iii) Emerging patients who are currently in possession of equipment or technical treatment at the third level of the city or at the municipal hospitals. Article 57 is in line with the comprehensive health insurance, inpatient health insurance, and inpatient health insurance, and requests for referrals to offshore medical institutions, and should be processed according to the following procedures: (i) A medical summary by a doctor of the three-tier hospitals or municipal specialist hospitals collected in the city, indicating the reasons for referral; (ii) A request for a medical examination by a doctor of the main medical clinic in the municipality of Shenzhen; (iii) After the referral of advice from the Director of the Hospital Section to the Medical Service Office or the Medical Service in charge of the medical supervision and supervision of the metropolitan hospital chapter, the disease approved by the targeted medical institutions may be transferred to the out-of-court medical institutions; the illness approved by the commune, which may be transferred to the outside-commune medical institutions after approval. Medical institutions receiving referral should be transferred to non-profit medical institutions at the same level or above. Article 588, when the farmers' health insurance workers are inpatient, is required for referrals from the former settlement hospital, where a referral certificate is made for the introduction of a referral or referral to a medical agency with a specialist director at the municipal level, and each referral hospital should send a referral certificate to a referral hospital. Article 599, after referral to the city, requires re-repatient treatment, should be provided by a pre-repatient medical institution with a referral certificate of referral and a referral medical institution should be a non-profit medical institution with the referral of medical institutions. Article 60 Long-term presence in the home country (non-ports, tyrans and tandems) of other cities shall select three local health-care institutions as their medical institutions for medical care and file with municipal social insurance institutions; The insured person who has long lived in other cities in the country should select three local health-care establishments for medical care in his/her place of residence, as well as a referral to the municipal social insurance institutions. Article 63/E provides for medical care for the actual medical expenses incurred by municipal social insurance agencies, which are not reimbursed by the standard of medical fees in the present city. The custodians should, at the national level, deduct from their personal accounts on basic medical costs and local supplemental medical costs. The medical expenses incurred by the insured person in line with this approach vary from home to home country, which are subject to the application of the insured person, are reviewed by the municipal social insurance agency for the actual medical expenses incurred and are reimbursed against the standard of medical fees and the standard of payment for the municipal hospitals. On his own request, the Social Insurance Agency has reviewed the actual medical costs, which are not higher than the medical fees in the city and the municipal hospital reimbursement standards. In accordance with article 62, the insured person is not subject to the procedures established under this scheme, to the hospitalization costs incurred by a medical agency outside the city of the social insurance agency for medical treatment, in accordance with the coverage of the health insurance fund, which may apply for reimbursement, but the rate of reimbursement is reduced by 20 percentage points, as provided for in this approach; the insured person has not been able to process the relevant procedures under this scheme, to the medical expenses incurred by the domestic non-status medical institution for medical treatment, in accordance with the provisions of the scheme. Chapter VI Article 63 provides for the establishment of targeted medical institutions, targeted retail stores, in accordance with the principles of harmonization planning, rationalization, facilitation of medical treatment, balanced needs, total control, encouragement of competition, and adaptation to the management capacity, information systems capacity. The municipal social insurance institutions should give priority to the selection of non-profit medical institutions as a targeted medical institution; non-profit medical institutions are chosen by the municipal social insurance agencies to identify targeted medical institutions and cannot be denied; non-profit medical institutions cannot meet the needs of health insurance services and are chosen by the municipal social insurance agencies to select medical conditions and social credibility as a targeted medical institution to select regulatory conditions and social credit fair retail pharmacies as a regular retail shop. Article 63 quantification of hospitals, clinics, social welfare centres, which are consistent with the following conditions, may apply to social security institutions in the city, enter into targeted health-care agreements and become targeted medical institutions: (i) Provide medical equipment and medical personnel commensurate with the level of medical institutions; (ii) To comply with the laws, regulations, regulations and other provisions relating to the management of medical services in the State, the Province of Broad East and the city; (iii) Strict implementation of the provisions of national, grass-roots, present-market provisions on non-profit medical fees and retail prices of medicines, and the introduction of a public indicative system for fees; (iv) Commitments for strict compliance with the relevant policy provisions of the current municipal social health insurance system, the establishment of an internal management system that is adapted to the health insurance management, with sound health insurance management organizations, leading the management of health insurance, equipped with the necessary dedicated management and computers to meet the needs of social health insurance. The medical institutions within the enterprise sector meet the conditions set out in the previous paragraph and the number of in-service employees in the unit is more than 1,000, may also apply for becoming a targeted medical institution to provide medical services to the insured person in the unit. Article 65 provides that the retail pharmacies meet the following conditions, may apply to the municipal social insurance institutions to enter into a targeted medical service agreement and become a targeted retail pharmacies: (i) Accreditation for the operation of medicines; (ii) To comply with the laws, regulations, regulations and regulations governing the management of medical services in the State, the Province of Broad East and the city; (iii) Strict implementation of the drug price policies established by the State, the Province of Broad East and the city; (iv) The availability of health insurance medicines in a timely manner; (v) In the course of the operation of the retail pharmacies, at least two pharmacologists with the qualifications of pharmacists or pharmacists (including pharmacists) should be given induction services; (vi) Undertake to strictly implement the relevant policy provisions of the current municipal social health insurance system, with normative internal management systems, equipped with the necessary management and equipped with computers that meet the needs of social health insurance; (vii) There are more than 80 per cent of the basic health insurance medicine catalogue and local supplemental health insurance medicines. Under the same conditions, retail pharmacies that lock the pharmacies and serviceable 24 hours, which do not operate goods other than medicines, medical devices, may opt for the identification of a customized retail pharmacies. Article 66 quantification of medical institutions and retail pharmacies is due in September each year to apply to municipal social insurance institutions; the municipal social insurance institutions should conduct an integrated assessment within two months and publish the assessment results, assesses the pre-empted medical institutions and retail pharmacies as a targeted medical institution and a terminal retail pharmacies. Article 67 of the Municipal Social Insurance Agency entered into agreements with targeted medical institutions and targeted retail pharmacies and administered in accordance with the agreement. In accordance with the provisions of this approach and the provisions of the agreement, the municipal social insurance institutions monitor and manage the targeted medical institutions, the targeted retail pharmacies, which are published every two years in compliance with their agreements. In accordance with the assessment of the results, the municipal social insurance agencies have given incentives to targeted medical institutions, the targeted retail pharmacies and related staff, and incentives are included in the sector budget of the municipal social insurance institutions. The criteria for determining the level of credit rating for the targeted medical institutions, the pharmacies, are developed by the municipal labour security sector in conjunction with the municipal quality technical supervision sector, which is followed by the approval of the municipal government. Article 68 medical institutions should uphold the principle of “therapeutic treatment, reasonable inspection, reasonable medication, reasonable treatment, and provision of fees”, and provide medical services to the insured person in accordance with the provisions and agreements of the scheme. Article 69 medical institutions should establish systems for medical treatment, pharmacization and management, regulating medical behaviours, strictly prohibiting the conduct of various orders for profit, reducing the proportion of the self-payment costs for medical care and alleviating the economic burden of the insured person. Article 76 quantified medical institutions, customized retail pharmacies should establish specialized health insurance management institutions, establish internal management systems adapted to the health insurance system, and implement self-management and self-binding. Article 76 quantified medical institutions and customized retail pharmacies should strictly implement the Government's provisions on medical fees and medicines prices and make them public. The targeted medical institutions shall provide the insured person with a detailed list of the fees or a list of the daily fees charged. In accordance with article 72, the targeted medical institutions shall be retained separately from the insured party, the medical examination of the medical treatment orders and the reporting documents, the examination of treatment orders, the list of medical costs, and shall be retained for at least two years in order to obtain a review by the municipal social insurance institutions. The customized retail pharmacies should be retained separately for the purchase of medicines by the insured person and for a detailed list, leaving at least two years for the purpose of obtaining a review by the municipal social insurance institutions. The provision of medical services by targeted medical institutions should be carried out in the form of a directory of essential health insurance and local supplemental health insurance, a medical treatment project, and the standards for the medical facility. Targeted medical institutions should obtain the consent of the insured person for pharmaceuticals, treatment projects, medical facilities other than those provided for in the preceding paragraph. The targeted medical institutions may not be included in the coverage of medical insurance accounts with other units, personal cooperation or contracted medical treatment projects. Article 76 quantified medical institutions should be found to be admitted to the insured person for medical treatment and for the medical expenses incurred. The insured person refused to present the relevant identification certificate, and the medical agency did not account for the medical costs incurred. The following elements should be reviewed when the pharmacies are purchased for the personal accounts of the insured person using the medical insurance: (i) Whether the social security card used by the insured person is owned by the insured person; (ii) Whether the custodian purchases the pharmacies have a specific medical agency; (iii) When the insured person purchases a non-participatory pharmacies, the accumulated personal accounts of the individual account reached the average monthly salary of the employee in the previous month of the previous year. Chapter VII Article 76 provides medical expenses actually incurred by customised medical institutions and custom retail pharmacies for the insured person to provide medical services, as prescribed or agreed by the scheme to settle with municipal social insurance institutions. Agreements between municipal social insurance institutions and targeted medical institutions and the terminal retail pharmacies should be negotiated. The coverage of the health insurance costs can be achieved through the settlement of the services project, the settlement of the service module, the settlement of the disease, the stereotyped settlement or the payment of the total amount. Article 7.17 The medical expenses incurred by the insured person in the purchase of medicines by the targeted medical institutions for medical care or at the targeted retail pharmacies are met in accordance with the following provisions: (i) It is covered by the Integrated Fund for Basic Health Insurance, the Local Supplementary Health Insurance Fund, the Reproductive Health Insurance Fund, which is accounted for by the targeted medical institutions; (ii) The extent to which the individual accounts are paid, withholding from the personal accounts of the insured person by the targeted medical institution or the customary retail pharmacies; and the underpayment of the individual accounts shall be charged directly to the insured person. Article 78 is one of the following medical expenses incurred by the custodian in respect of medical treatment, paying cash first and then, on the basis of the application of the relevant documents and information to the social insurance institutions of the city, and is reimbursed by the municipal social insurance institutions as provided: (i) Integrated medical insurance, inpatient health insurance coverage, or inpatient medical expenses incurred in other cities in the country through approval; (ii) The long-term presence of presenters working in other cities in the country or the occupants who lived in other cities in the country after retirement, and the medical costs incurred in the case of medical institutions; (iii) Accused medical body to carry out a diagnosis of chronic kidney functionality, a post-planet medical treatment to combat exclusion, as well as medical costs incurred in the treatment, treatment, therapy or treatment of stereotypes; (iv) Inpatient health insurance costs incurred by farmers' workers in connection with their work or travel, and in-patient medical expenses incurred by non-discipline hospitals for emergency care; (v) The cost incurred by the insured person, with the consent of the hospital, in the case of the inpatient care project outside the school; (vi) The cost of maternity health care in other cities in the country in line with the provisions of the scheme. Article 79. Inpatient health insurance and inpatient health insurance for farmers are one of the following cases for medical treatment, paying cash prior to payment, and may subsequently be reimbursed by the settlement hospitals through the application of the relevant documents and information to the settlement hospitals or designated medical institutions: (i) In the case of illness, the fees for referrals to non-settlement hospitals were approved by the settlement hospitals; (ii) Emerging medical expenses incurred in non-settlement hospitals due to work out or travel; (iii) Inadequate computer failures or damage to the social security card are not accounted for by the medical establishment of the medical care. Farmers' health insurance workers are allowed to receive reimbursement from the relevant vouchers and information to the settlement hospitals by granting referrals to the designated medical facility. Article 810 Medical expenses incurred in hospitalization or in-patient medical treatment of the insured person, with one of the following cases paying cash, may be reimbursed by the relevant documents and information to the medical facility for medical treatment: (i) Inadequate computer failures or damage to the Social Security Cartages for the medical care-seeking medical institutions; (ii) As agreed by the hospital, in-patient medicines are purchased within the scope of the basic health insurance catalogue. Article 81 shall submit the following information within 12 months of the date on which medical expenses have occurred (from the date of the inpatientation): Referral of hospital referrals, messaging or inpatient medical photocopies, disease diagnosis certificates (therapeutic), board diagnostic certificates or boarding (patients), schedules of fees, original fee receipts, personal certificates and social security cards. Article 82, the permanent residence of the occupants of the city after retirement, and upon application by themselves, the balance of their health insurance personal accounts and the amount to be transferred to social insurance institutions in their long-term residence under this scheme; the personal accounts cannot be transferred and, upon request, a one-time payment may be made available to themselves to enter their pension accounts; their monthly accounts shall be transferred to the individual account for the benefit of their pension in accordance with the provisions of Article 41 of this scheme. The permanent residence of retirees from non-residents who are paid for old-age insurance treatment by the municipal social insurance agencies in other places, upon request by themselves, has been transferred to the Integrated Community Uppatient Insurance Fund in the amount of their monthly cash accounts for the receipt of pension insurance payments and no treatment under article 43 of this scheme. Chapter VIII Oversight inspection Article 83 Social Insurance institutions should establish a financial system for the health insurance fund and make payments to society. Article 84 provides regular audits of the payments, closures and management of the Medical Insurance Fund by law and the results of the audit are communicated to the Standing Committee of the Social Insurance Fund. Article 82 should strengthen the supervision management of targeted medical institutions at all levels, incorporate the implementation of health insurance provisions into the examination of the integrated objective management of the targeted medical institutions and link the responsibility of the President for the term of office. Article 86 should enhance the supervision of targeted medical institutions and targeted retail pharmacies in the implementation of national, broader, current and pharmaceutical price policies. The municipal drug control management should enhance surveillance of the quality of medicines for targeted medical institutions and targeted retail pharmacies. Article 87 established a Committee of Experts on Health Insurance by the Municipal Social Insurance Agency to undertake the following tasks: (i) To provide technical advice on health-related policies for the municipal labour security sector in line with this approach; (ii) Provision of technical guidance to the municipal social insurance institutions for the conduct of health insurance surveillance inspections, providing expert advice on the problems of medical doubts arising from inspections; (iii) Provision of expert advice for the establishment of health insurance clinics for social insurance institutions; (iv) To provide expert advice on the dispute between the insured person and the targeted medical institution, and to undertake a comprehensive assessment of the reasonableness of the cost of the ALT; (v) Other health insurance tasks assigned by municipal social insurance institutions. Funding for the work of the Committee of Experts on Health Insurance is included in the sectoral budget of the municipal social insurance institutions. Article 8XVIII shall be made available to the worker every half a year for the payment of the medical insurance fee. The insured unit and the insured person have the right to consult the municipal social insurance agencies on the contributions of the unit or his own medical insurance, the treatment paid. The municipal social insurance institutions should facilitate access to the security units and the insured person. Any unit or individual has the right to sue, prosecute targeted medical institutions, class retail pharmacies, participate in the security units, attend the insured person and work in the municipal social insurance institutions. Following the verification of the reporting content, the municipal social insurance agencies have given incentives to the prosecution from the provision of incentives, and the specific approach has been developed. The staff of the municipal social insurance institutions and the health insurance supervisors employed are subject to supervision inspections by targeted medical institutions, targeted retail stores, insurance units and insured persons. The targeted medical institutions, the pharmacies, are unable to provide all information as required or provided, and the municipal social insurance agencies may refuse to pay the corresponding costs. When the municipal social insurance agencies check the payment of royalties to the insured units, it may request the inspectorate to provide information relating to the payment of medical insurance payments, the salary scales, the financial statements, etc., which can be recorded, recorded, video, photographed and replicated, but shall be confidential to the inspectorate. In the case of a medical institution, the insured person shall present his own social security card. In the event that the insured person loses the social security card, the social insurance institution should be kept in a timely manner; the medical expenses incurred during the separation of office may be reimbursed by the relevant documents and documents to the municipal social insurance institutions, which the medical costs incurred by the insured person shall be deducted from the individual accounts as provided in the scheme. The loss of the social security card of the insured person resulting in the loss of the integrated health insurance fund may be paid by the municipal social insurance agencies or by the person. Article 93, Partners and targeted medical institutions may apply for coordination with the municipal social insurance institutions, which may require expert advice from the Committee of Experts on Health Insurance to determine the date of receipt within seven working days. Chapter IX Legal responsibility Article 94 does not pay the medical insurance expenses as prescribed, and is treated in accordance with the provisional regulations for social insurance payments and the relevant provisions of the Labour Safeguards Monitoring Regulations. The medical expenses incurred by the insured person during the period were not paid by the prescribed medical insurance payments, which were paid by the user's unit in accordance with the criteria set out in the scheme; the impact of the continuing attendance of the insured person and the loss of its health insurance treatment was partly paid by the user's unit in accordance with the standards set out in the scheme. Article 9XV provides for treatment under the agreement with the Social Insurance Agency, which is suspected to be committed by the judiciary. Article 96 provides that customised medical institutions, targeted retail pharmacies violate price management provisions, drug management provisions or health-care management, and municipal prices, medicines, health management shall communicate the results in a timely manner to the social insurance institutions. Article 97 participated in the health insurance scheme for persons not in compliance with the coverage of I's municipal health insurance, which was ineffective in the health insurance relationship of the insured person, which had been paid to the insured units and individuals, while the municipal social insurance agency could impose a fine of up to $50 million for those participating in the insurance unit; the costs paid for the integrated health insurance fund were recovered by the municipal social insurance institutions; the alleged offences were transferred to the judiciary. Article 98, unit or individual fraud in the health insurance fund, was returned by a junction from the municipal labour security sector, in serious circumstances, by a fine of more than three times the price of the municipal labour security sector, which was charged with the offence, and transferred to the judiciary. Article 99 impedes, obstructs the inspection and investigation of evidence by members of the municipal labour security sector, municipal social insurance agencies, and is dealt with in accordance with the provisions of the Law on Justice Management of the People's Republic of China. Article 101 Staff members of the municipal social insurance institutions misuse their duties, play negligence, favouring private fraud and are lawfully disposed of; the alleged offence is transferred to the judiciary. Article 101 provides for administrative review or administrative proceedings against the municipal labour security sector, the municipal social insurance agency, which is not consistent by the law. Chapter X Article 105, which was approved by all levels of government, has been established at the Graduate Institute, which can be implemented in the light of the provisions of the comprehensive health insurance scheme, inpatient health insurance, with the participation of schools in the payment of health insurance payments. Article 101 ter allows companies to draw up additional medical insurance fees by 4 per cent of the total employee's salary, to cover the complementary treatment of health insurance for enterprises, from the employee welfare fee, and specifically by the municipality. The medical safeguards scheme for dispensing personnel and first to six-year-old soldiers (removable military personnel, such as the former pharmacies, etc.) are developed separately by the municipality. Article 101 V Aboriginal Urbanization Officers participate in health insurance and contributions as a user unit. Article 101, paragraph quinquies are higher for self-payment, resulting in a lower standard of living than the minimum level of living in the city, which is unable to pay medical expenses, may apply to social security institutions in the city for special subsidies to cover medical costs, specifically by the municipal labour security sector to be established separately from the financial, civil affairs sector. Article 101 VII of the municipal labour security sector may develop a health insurance package based on this approach. The average monthly salary of the last-year occupier in the municipality is limited to the data published by the municipal statistical offices. The average monthly salary of the last-year occupier in the city referred to in this scheme is calculated at the average monthly salary of the previous two-year occupier in the first two-year occupier in the first half of the year, calculated at the average monthly salary of the previous occupier. The health insurance year referred to in Article 101 of this scheme is 1 July to 30 June. Article 101, paragraph 2, of this approach contains the following: Article 101 of this approach was implemented effective 1 March 2008, and the Social Health Insurance Scheme (No. 125) of the Shenzhen Town of 27 May 2003 and the Provisional Approach to Labour Health Insurance in the Shenzhen City had been repealed since its inception. |
