Interim Measures For The Agricultural And Pastoral Areas In Tibet Autonomous Region Medical Management

Original Language Title: 西藏自治区农牧区医疗管理暂行办法

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(November 22, 2006 the people's Government of Tibet Autonomous Region, the 27th Executive meeting on November 30, 2006 the people's Government of Tibet Autonomous Region promulgated as of January 1, 2007, 75th) Chapter I General provisions article to further implement free medical care policy, establishing and perfecting the agricultural and pastoral areas based on free medical health care system, promote the development of agricultural and pastoral areas of health, improve the health of farmers and herdsmen, in accordance with the
    The CPC Central Committee decision on further strengthening rural health work under the State Council and the CPC Tibet Autonomous Regional Committee of the Tibet Autonomous Region people's Government decision on further strengthening the agricultural and pastoral areas health, these measures are formulated.
    II agricultural and pastoral areas health care system is Government-led, financing for the Government, collectives and individuals, mainly for family accounts and catastrophic basic medical insurance system for farmers.
    Third agricultural and pastoral areas health care system, adhere to the voluntary and multilateral funding, in order to support and ensure an appropriate degree of principle.
    Article fourth agricultural and pastoral areas health care system for agricultural and pastoral areas with agricultural permanent residence wubaohu and without the ability to work, no source of livelihood, without legal support or maintenance (maintenance) people or the elderly, the disabled and minors suffering from a serious illness, and personal burden of medical costs are too high, affect the basic life of people medical help.
    Five Governments at all levels should establish agricultural and pastoral areas and improve the medical system into local economic and social development plans, as an important part of establishing social security system in agricultural and pastoral areas, careful organization.
    Sixth chapter organization and management in agricultural and pastoral area health care system by County (city, district) in units of co-ordinating, counties (cities and districts) according to the actual situation, the implementation of County (city, district) management and the County (city, district) and township (town) management.
    Seventh article autonomous regions, and to (City) established by health, and financial, and personnel, and home, and agricultural MU, and audit, and monitored, and development and reform, and labor and social security, and poverty, and publicity, and broadcast Movie TV, and education, and FMC, and national religious, and food drug supervision, and population and family planning, sector composition of agricultural and pastoral areas medical coordination led group, is responsible for organization, and check, and guide and coordination agricultural and pastoral areas medical work.
    Autonomous region, Prefecture (City) in agricultural and pastoral areas set up by the Administrative Department of health medical coordination leading Group Office, staffed with full-time staff, responsible for the management of agricultural and pastoral areas of medical work.
    Article eighth County (city, district) and township (town) people's Government was established consisting of representatives from relevant government departments and farmers and herdsmen in agricultural and pastoral area medical Management Committee (hereinafter referred to as the HA), responsible for the Organization, coordination, management, agricultural and pastoral areas guidance and supervision of medical work. The County (city, district) health administrative departments and township (town) people's Government established agricultural and pastoral areas of medical management office (hereinafter referred to as the HA), solved by transfers of the Government at the same level of its staff. The County (city, district) to equip fulltime staff of the HA, the township (town) the pipe is equipped with (and) staff responsible for management.
    Medical Office staff and funding included in the budget at the same level shall not be extracted from the medical fund.
    County (city, and district) medical tube do of duties: (a) according to this approach developed work programme and the regulations, and by County (city, and district) medical tube will discussion through Hou organization implementation; (ii) Organization carried out publicity, and launched work; (three) management County (city, and district) agricultural and pastoral areas medical Fund; (four) issued medical documents; (five) coordination solution implementation work in the of specific problem; (six) collection, and finishing, and analysis and reported related information; (seven) supervision, and check and assessment the Xiang (town) medical tube will and Office of work.
    Xiang (town) medical tube do of duties: (a) organization implementation County (city, and district) medical tube do developed of work programme and the regulations; (ii) Organization publicity, and mobilization HONGO (town) farmers and herdsmen participate in medical funding, and is responsible for registration registered and sent card work; (three) is responsible for raised farmers and herdsmen personal pay of costs and on time handed County (city, and district) medical tube do; (four) management agricultural and pastoral areas family account Fund; (five) collection, and analysis, and finishing and reported related information.
    Medical objects in chapter III rights and obligations Article Nineth agricultural and pastoral areas health care system applicable to enjoy free medical treatment policy of the farmers and herdsmen.
    Article tenth of agricultural and pastoral areas of medical objects: (a) free medical care, (ii) access to basic health-care services, (iii) medical compensation under (iv) advice and recommendations to the medical institutions at all levels; (v) supervising the medical fund management in agricultural and pastoral areas, and violations of the relevant provisions of the report.
    11th pastoral area medical obligations: (a) abide by the agricultural and pastoral areas of medical management Charter and regulations and (ii) in household voluntary individual financing; (c) the medical policy consciously promote agricultural and pastoral areas and (iv) cooperate with health agencies health care.
    The fourth chapter medical fund raising agricultural and pastoral areas and management article 12th Medical Fund Government, personal finance, group support and social support through various channels of financing mechanisms.
    Medical Fund of source: (a) national arrangements of free medical special funding and new rural cooperation medical grants funding; (ii) autonomous regions, and to (City), and County (city, and district) Government financial arrangements of free medical special funding; (three) farmers and herdsmen personal annual voluntary pay of funding (standard not below 10 Yuan); (four) County (city, and district) home administrative competent sector for meet medical rescue conditions of farmers and herdsmen generation make of personal funding; (five) enterprises, and social groups and personal of donor;
    (Vi) interest income arising from agricultural and pastoral area medical funds; (VII) other sources.
    Article 13th participation in financing for agricultural and pastoral areas of medical personnel change of household registration, personal finance does not back up that year, by their family members continue to be used.
    New financing for personal family or household population, bounded by June 30, attended before payment of all fees, attended after paying fees. 14th medical fund agricultural and pastoral areas are divided into family accounts, serious illness, medical risk and medical help four categories. Its proportion and purpose is: (a) the family accounts Roh Fund. 50%~60% of the total Fund.
    Mainly used in outpatient medical and health costs of compensation of farmers and herdsmen.
    On voluntary pay personal funding of farmers and herdsmen family, from the households agricultural and pastoral areas medical Fund total (personal funding to per capita 10 Yuan calculation) in the by 50%~60% designated into its family account, personal funding over 10 yuan of, beyond part full designated into its family account; on not pay personal funding of farmers and herdsmen, from the households free medical special funding and cooperation medical grants funding in the by 50%~60% designated into its family account. (B) serious illness Fund. 33%~43% of the total Fund.
    Compensation primarily for hospital medical expenses of farmers and herdsmen. (C) medical venture fund. Total Fund of 2%. Mainly used to compensate for the catastrophic Fund due to abnormal increase in the number who, resulting in non-normal cost overruns of the emergency funds.
    Risk-the size of the Fund should be maintained at around 10% per cent of total annual funding, up to the required size no longer extracted. Medical risk fund is administered by the County (city, district) established.
    Use of the risk fund, the County (city, district) hospital will submit a written application, (City), agricultural and pastoral areas of medical management and coordination leading group for approval. (D) Medical Fund. Total Fund of 5%.
    The County (city, district) District Administrative Department in accordance with the relevant provisions of management and use.
    Family account Fund and Fund for catastrophic proportions, by regional (City) within the range specified in the autonomous region, determined according to the local reality, report the coordination leading Group Office agricultural and pastoral areas of the autonomous region. 15th in agricultural and pastoral area health system County (municipal and district) of unified management, family Fund, catastrophic funds and risk funds by County (city, district) medical office management. Implementation of County (city, district) and township (town) of common management, its catastrophic risk fund and medical funds by County (city, district), medical office management, household account Fund is administered by the County (city, district) allocated to each of the HA of township (town) HA management.
    Medical Relief Fund, administered by the County (city, district) HA allocated to County (municipal and district) Administrative Department of home management. 16th in agricultural and pastoral area medical funds should be classified accounts, settled by class, continue to use surplus carried forward to the next year. The County (city, district) and township (town) the HA should be in accordance with the accounting and financial systems, financial accounting of income and expenses of the Fund, establish and perfect the financial accounting archives and various rules and regulations, standardize financial and accounting management.
    Medical fund accounting accounting and finance management in agricultural and pastoral areas specific measures formulated by the State financial administrative departments. Agricultural and pastoral area medical funds into all levels of financial budget and final account.
    All funds must be in State-owned commercial banks opened special financial account, special account for implementation of storage, project management, earmarks, no unit or individual is allowed to borrow a, interception, misappropriation and misuse.
    Fifth chapter medical expense compensation refers to compensation article 17th medical costs farmers after medical treatment in medical institutions at all levels in accordance with the regulations waive, write-off or reimbursement of medical expenses.
    18th medical expenses should be open, fair, equitable, timely and convenient principle. 19th article on pay personal funding of farmers and herdsmen, in levels medical institutions medical claims compensation of proportion and the specific settlement approach by following provides implementation: (a) in Xiang (town) medical institutions and village health room (village doctor) medical by occurred of outpatient costs, by family medical account this in its family account Fund in the verification; in Xiang (town) medical institutions medical by occurred of hospital costs, from received 70%~85%.
    The township (town) hospitals and village clinics (country doctor) with cancellation and waiving of medical fees effective instruments, and township (town) and County (city, district) HA are settled periodically. (B) in the County (city, district) medical costs incurred by hospitals for medical treatment, outpatient costs based on family accounts of the family medical account fund expenses; medical expenses by the accounts of family medicine and medical cost effective instrument, in the catastrophic Fund reimbursement 70%~80%.

    (C) in (City) medical costs incurred by medical institutions for treatment, outpatient costs based on family accounts of the family medical account fund expenses; medical expenses on the family medical account, County (city, district) referral referral certificate and medical expenses in medical institutions effective instruments in the catastrophic Fund reimbursement 60%~70%. 20th article on not pay personal funding of farmers and herdsmen, in levels medical institutions medical claims compensation of proportion and the specific settlement approach by following provides implementation: (a) in Xiang (town) medical institutions and village health room (village doctor) medical by occurred of outpatient costs, by family medical account this in its family account Fund in the verification; in Xiang (town) medical institutions medical by occurred of hospital costs, from received 50%~65%.
    The township (town) hospitals and village clinics (country doctor) with cancellation and waiving of medical charges with a valid ticket, and township (town) and counties (cities, districts) HA are settled periodically.
    (B) in the County (city, district) medical institutions in medical expenses for the medical treatment, outpatient costs based on family accounts of the family medical account fund reimbursement; hospitalization costs with the family health and medical expenses of the account of the effective instruments in the catastrophic Fund reimbursement 50%~60%.
    (C) in (City) the medical institution's medical expenses and outpatient costs based on family accounts of the family medical account fund expenses; medical expenses on the family medical account, County (city, district) referral referral certificate and medical expenses in medical institutions effective instruments in the catastrophic Fund reimbursement 40%~50%.
    Article 21st claims compensation limits, and farmers and herdsmen to pay individual premium medical compensation, periods not exceeding 8000 Yuan per person per year; medical compensation for unpaid personal financing for farmers and herdsmen, accrued up to 6000 Yuan per person per year.
    Ratio of compensation and reimbursement of specific quotas, local (City) within the range specified in the autonomous region, determined according to the local reality, report the coordination leading Group Office agricultural and pastoral areas of the autonomous region.
    Meet the requirements of medical aid, the County (city, district) district administrative departments of medical relief. 22nd peasants and herdsmen in maternal hospital medical expenses in medical institutions at all levels, with the family medical accounts, counties (cities and districts) referral referral certificate and medical expenses in medical institutions effective instruments, implemented in the catastrophic Fund reimbursement limit.
    Limit standard formulated by the health Administrative Department of the autonomous region. Introduction of farmers and herdsmen in maternal hospital delivery incentives. Where farmers and herdsmen in maternal hospital delivery of medical institutions at all levels, a one-time award of maternal 30 yuan, rewards escort 20 Yuan.
    Awards funded by the County (city, district) in the catastrophic Fund expenditure of the HA.
    Sterilization and delivery of maternal families of farmers and herdsmen, waiving their medical costs incurred from medical institutions with free medicine cost effective Bill, proof of birth register and signed by the parties, and County (city, district) run regularly in the catastrophic Fund in the medical billing. Article 23rd to farmers and herdsmen in the school primary, per person per year from their family account funds extracted from 50%, run by the HA to allocate to the school management, outpatient medical costs paid by the school from the management of funds.
    Hospital costs by school prove, family health and medical expenses of the account of the effective instruments in their Hukou County (municipal and district) run according to the provisions of the medical claims. 24th article district within monks and nuns household location and now live to inconsistent of, according to territorial management of principles, can participate in Temple location of agricultural and pastoral areas medical system, by Temple location of County (city, and district) medical tube do issued family medical account this, its free medical special funding by Temple location of County (city, and district) medical tube do up level related sector application designated turned and management using, by occurred of medical costs, by family medical account this and medical costs effective notes, to Temple location of County (city, and
    District) and township (town) hospital reimbursement according to local regulations.
    25th cross-prefectural (City) and County (city, district) movement of farmers and herdsmen in the region, medical expenses in foreign medical institutions for treatment, by proof of work, of the accounts of family medicine and medical cost effective instruments in the domicile of the County (city, district) run according to the provisions of the medical claims. Article 26th households of farmers and herdsmen account funds in savings in the current year, carried forward to the next year.
    Families of farmers and herdsmen account funds used, at all levels of medical outpatient costs incurred by the institution, by individuals themselves; hospitalization costs reimbursed by the regulation. 27th the County (city, district) and township (town) should strictly implement the reimbursement provisions of the HA, for a variety of documents and vouchers carefully vetted to eliminate debt reimbursement and fraud and other acts.
    Reimbursement of compensation should be convenient for farmers and herdsmen to simplify formalities and procedures, timely reimbursement of compensation, without undue delay, denial.
    28th article medical costs not claims compensation of range: (a) alcohol, and suicide, and self-mutilation, and fights, and drug, and traffic accident, and medical accident, occurred of medical costs; (ii) orthopaedic, and beauty, and veneers, and distribution glasses, and installation prosthetic and the other health supplies of costs; (three) since purchased drug, and nutrition health products of costs; (four) conscription, and recruitment, and entrance medical fee, transportation (transport pregnancy maternal hospital delivery and rescue of except);
    (V) unauthorized referral referral (City), the medical examination and treatment in medical institutions above; (vi) in different places to work, school and other mobile workers without relevant certificates, medical expenses incurred (except for the acute and serious illness); (VII) registration fee, visit fees.
    Sixth chapter 29th medical services management the County (city, district) and township (town) hospitals and village clinics (country doctor), is the subject of providing health care services for farmers and herdsmen, implement fully extended, provided to farmers and herdsmen, timeliness, convenience, quality, affordable health care services. 30th the County (city, district) and township (town) medical institutions shall set up roving medical and health service system to the countryside, to facilitate medical.
    The County (city, district) health administrative departments of medical institutions should be organized for the farmers and herdsmen regular health examination carried out on a regular basis, and township (town) medical institutions to set up family health records. 31st the County (city, district) and medical institutions should seriously implement the above referral referral system.
    Referral referral shall meet the following conditions: (a) critical or difficult cases, diagnosis of the disease is unknown, treatment, level on the need to make further checks and treatment in medical institutions, (ii) the County (city, district) medical examination and approval.
    For special cases need referral hospitals and not obtaining approval in time, counties (cities and districts) HA can be audited.
    Article 32nd medical institutions and medical staff should practise according to law and strictly abide by the code of ethics, implementation of the rules and regulations and medical technology practice for agricultural and pastoral areas, and medical care fees, be due to illness and treatment, reasonable examination, rational drug use, treatment, medical registration, drug prescriptions, pay as you take notes.
    Medical institutions and medical staff should ensure that the quality of service, improve service efficiency and unreasonable control of medical costs, and reduce the burden on farmers and herdsmen.
    33rd levels in agricultural and pastoral area health agencies and medical organizations should do medical cost clearing.
    Article 34th State departments of health, food and Drug Administration is responsible for County (city, district) and township (town) medical institutions, essential drug list and drug distribution management solution. Agricultural and pastoral areas using drugs in medical institutions, the implementation of regional (City) organized public bidding, County (city, district) specific procurement, bid distribution system.
    Strengthening the agricultural and pastoral areas drug tendering, supervision and management of all aspects of procurement, distribution, ensuring that farmers and herdsmen medication is safe and effective. Seventh chapter medical document management article 35th of farmers and herdsmen to implement a certified doctor.
    Units of households of farmers and herdsmen, door-to-door by people registered by the villagers ' Committee, by the township (town) approved by the HA, reported to County (municipal and district) medical examination, issue of the family medical account.
    The County (city, district) district administrative departments to of generations of farmers and herdsmen eligible for Medicaid personal funding allocated to the County (city, district) after the HA, to be issued by the accounts of family medicine. Article 36th of the family medical account uniformly printed by the State Administrative Department of public health.
    The family medical account shall not be altered, forged or transferred.
    Eighth chapter of medical management and supervision article 37th County (municipal and district) people's Government shall be established by the supervision and auditing, finance, health, agriculture and animal husbandry, civil affairs departments and the agricultural and pastoral areas of medical Oversight Committee made up of representatives of farmers and herdsmen, and the watchdog has set up an Office responsible for agricultural and pastoral areas of medical management and supervision work.
    State and prefectural (City) annual agricultural and pastoral areas on the medical work of the relevant departments should conduct special supervision and inspection.
    Article 38th medical treatment including management and supervision and management oversight, special management oversight and reports complaints admissible.
    Medical management oversight includes free health care implementation of special funds, fund raising, management and expenditure, medical services, drug management, and so on.
    39th audit departments shall free medical care on a regular basis special funds and medical expenditure and management audit.
    40th County (city, district) and township (town) people's Governments shall regularly report to the national people's Congress at the same level on agricultural and pastoral areas of medical work, take the initiative to accept supervision.
    County (city, and district), and Xiang (town) medical tube do should regularly to County (city, and district), and Xiang (town) medical tube will and supervision Committee reported Medical Fund of payments and using situation; established claims compensation publicity system, on medical Fund of specific payments, and management and farmers and herdsmen benefit situation, should regularly notice announced, to guarantee farmers and herdsmen participation, and informed and supervision of right.
    41st found problems in the agricultural and pastoral areas medical supervision, the departments concerned should be corrected or dealt with in a timely manner.
    Nineth chapter supplementary articles article 42nd town residents who enjoy free medical care in accordance with the measures implemented. 43rd local (municipal) Administrative Office (Government) according to these measures, formulate implementing rules.

    44th article of the approach by the State departments of health and Finance Administration is responsible for the interpretation. 45th article of the rules implemented on January 1, 2007.
                                                                                July 15, 2003 issued by the people's Government of the Tibet Autonomous Region, Tibet Autonomous Region, agricultural and pastoral areas of medical management of the interim measures (the people's Government of Tibet Autonomous Region, 56th) repealed simultaneously.

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