Rules Of Shenzhen Urban Medical Insurance System For Urban Employees

Original Language Title: 深圳市城镇职工社会医疗保险办法

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(May 27, 2003, Shenzhen People's Government released 125th) Chapter I General provisions article for establishing and perfecting the medical security system in Shenzhen, ensure basic medical rights, in accordance with relevant laws and regulations, combined with the city's actual, these measures are formulated.
    Second city to implement the social medical insurance system for urban employees.
    Governments establish the basic medical insurance, supplementary medical insurance and maternity medical insurance medical insurance system.
    Government medical benefits for civil servants, and encourage and support enterprises to establish supplementary medical insurance.
    This article, all employers and employees must be evaluated in the regulations the basic medical insurance, supplementary medical insurance and maternity insurance.
    Employers in these measures refers to all bodies within the administrative area of the city, institutions, social organizations, enterprises and private non-enterprise units, agencies.
    Workers in these measures refers to employer-owned incumbent, retired as provided herein and has residence in this city of unemployed persons receiving unemployment benefits during the.
    Participants in these measures refers to having participated in social health insurance employer.
    The insured mentioned in these measures refers to workers participating in the social medical insurance.
    Article fourth social medical insurance system should be guided by fairness and efficiency combined, right corresponding to obligations, security levels commensurate with the level of development of social productive forces of the principle.
    Five basic social healthcare integrated and combined with personal accounts of fund management.
    Supplementary health insurance and maternity social pooling healthcare.
    Basic medical insurance, supplementary medical insurance and birth health insurance funds the social security financial accounts, the two lines of income and expenditure management, earmarked misappropriated is strictly prohibited.
    Basic medical insurance, supplementary medical insurance and birth health insurance fund due to special situations such as disease outbreaks, natural disasters, and inadequate when, financially subsidized by the city.
    Article VI-basic medical insurance medical insurance and hospitalization insurance in two forms.
    Following personnel participate in integrated medical insurance: (a) has this city household (containing blue printing account, to with) of on-the-job personnel; (ii) retired Qian has this city household, by city social security institutions by months paid pension insurance treatment of retired personnel; (three) retired Qian has this city household, participate in original pension insurance industry and manpower and by Guangdong Province social security institutions by months paid pension insurance treatment of retired personnel; (four) Municipal Government provides of other on-the-job personnel.
    The following persons to participate in medical insurance: (a) non-household registration incumbent in the city; (b) the monthly payment of old-age insurance benefits, social security institutions, household registration, non-retirees, and (iii) has a residence in this city, people claiming unemployment benefits during unemployment.
    Employer application for non-household registration incumbent in the city can also participate in the comprehensive medical insurance.
    Article seventh participation in comprehensive health insurance or hospital personnel should also participate in local medical insurance supplementary health insurance.
    Has the city's household registration incumbent should also participate in maternity medical insurance.
    Article eighth Shenzhen Municipal People's Government (hereinafter referred to as the city) established by the municipality for Administration of social insurance institution (hereinafter referred to as municipal social security institutions), health insurance, in charge of the work.
    Health, pharmaceuticals, pricing, planning, finance, social insurance institutions, and other relevant departments should assist medical insurance.
    Chapter II collection of medical insurance premiums article sources for basic medical insurance fund, basic medical insurance premiums and interest, financial subsidies and other income.
    Sources for local supplementary medical insurance fund, supplementary medical insurance and interest and other income.
    Maternity health insurance fund comes from the reproductive health insurance costs and interest and other income. Article basic medical insurance, supplementary medical insurance and childbirth insurance premiums shall be determined in accordance with the following base pay: (a) staff participating in the comprehensive health insurance, my monthly wages contribution base. On-the-job personnel I wage total over this city Shang annual town workers monthly wage 300% of, to this city Shang annual town workers monthly wage 300% for payment base; months payroll below this city Shang annual town workers monthly wage 60% of, to this city Shang annual town workers monthly wage 60% for payment base; (ii) participate in hospital medical insurance of personnel, to this city Shang annual town workers months average for payment base; (three) sixth article second paragraph second items provides of retired personnel,
    With its monthly basic pension for base pay; (d) the sixth article III provided for retirees, just before his retirement, urban workers ' monthly salary of the previous year, the contribution base (v) local supplementary health insurance and maternity health insurance contribution base, established in accordance with its basic medical insurance contribution base. 11th the employing units and employees in accordance with the following standards to pay basic medical insurance, supplementary medical insurance and maternity medical insurance: (a) comprehensive medical insurance, workers at 8% of the base pay, which the employer to pay the 6%, serving the individual to pay the 2%; sixth retirees provided for in the second paragraph of the second item, By the municipal organization of social insurance payment under the contribution base 11.5%, costs from the Masonic Fund would be covered by the basic old-age insurance sixth retirees provided for under the second paragraph of article III, the former employer before the employee retirement lump x18 base 11.5%x12 a month paid; (b) hospitalization insurance, article sixth workers referred to in item III, By employing units by payment base of 0.8% paid make; sixth article third paragraph second items and third items provides of personnel, by city social security institutions by payment base of 0.8% paid make, costs respectively from basic pension insurance total Chai Fund and unemployment insurance fund expenditures; (three) place added medical premium, participate in integrated medical insurance of, by payment base of 0.5% paid make; participate in hospital medical insurance of, by payment base of 0.2% paid make.
    Apart from the staff paid by the employer, other channels of payment and payment methods according to the first two regulations; (d) reproductive health insurance payment under the contribution base of 0.5% by the employer.
    12th basic medical insurance, supplementary medical insurance and maternity medical insurance premium by the insured's Bank on a monthly basis after collecting, transferred to the social insurance fund of the social insurance institutions to open bank accounts. 13th article parameter insurance units and parameter assured paid make of social medical premium, by city social security institutions respectively established medical insurance and manpower Fund and personal account, unified for management, specific approach for: (a) integrated medical premium, personal paid make of part all meter into personal account; employing units or city social security institutions paid make of part, 35 age (not containing 35 age) following of on-the-job parameter assured, 30% meter into personal account; 35 age above 45 age (not containing 45 age) following of on-the-job parameter assured,
    40% meter into personal account; 45 age above of on-the-job parameter assured, 50% meter into personal account; sixth article second paragraph second items provides of retired personnel, 60% meter into personal account; sixth article second paragraph third items provides of retired personnel, by Shang annual town workers months average X11.5%x60% meter into personal account; other part meter into basic medical insurance and manpower Fund; (ii) hospital medical premium all meter into basic medical insurance and manpower Fund, not established personal account;
    (C) local supplementary medical insurance included in supplementary medical insurance fund, not a personal account, earmarked for local supplementary medical insurance benefits paid (d) reproductive health insurance all included maternity insurance fund, not a personal account, earmarked to pay maternity medical insurance costs.
    14th an employer in setting up or 30th days after obtaining the business license, shall be registered with the municipal social security institutions for medical insurance and insurance procedures.
    Article 15th consecutive residence in this city of more than one year of basic medical insurance insured due to job changes, for which no employer paid medical insurance premiums can be paid by my continuous, and treated as a continuous payment, but I pay period should not be longer than 3 months in a row.
    16th enterprise to pay health insurance costs included in the cost of, medical insurance premiums payable by the institution in administrative outlay expenditures; medical insurance premiums payable by the individual in front of the tax paid.
    Article 17th of social medical insurance funds and the funds in the account of the insured individual according to relevant regulations of the State interest.
    18th city in accordance with economic developments, wage growth, price levels, and medical expenses, the actual situation, the employer and employee to pay basic medical insurance, supplementary medical insurance and maternity medical insurance standards accordingly.
    19th chapter III medical insurance treatment the insured under insurance formalities since from 1st to enjoy medical insurance benefits as provided herein.
    An insured person or their units to stop paying health insurance premiums, stop paying month 1st insured ceased to enjoy medical insurance, but except for the personal account section.
    Article 20th basic medical insurance the insured enjoy medical insurance drug list, medical projects and medical services within the scope of the standard of medical treatment and other medical treatment provided.
    Local supplementary medical insurance of an insured person under the present system of local supplementary medical insurance benefits.
    Reproductive health insurance of an insured person under the present system of reproductive health insurance benefits.
    21st medical insurance drug list, projects carry out the admittance system of diagnosis and treatment. Basic medical insurance drug list in accordance with the national and social security management Department of Guangdong Province published directories; basic medical insurance diagnosis and treatment projects, medical services and facilities standards and local supplementary medical insurance drug list and treatment project developed by the municipal social security institutions, and to the public.

    Serving officers of the 22nd to have comprehensive medical insurance, basic medical care for the hospital costs are covered by the basic medical insurance fund 90%, out-of-Pocket 10% participation in comprehensive health insurance for retirees, the hospital's medical costs are covered by basic medical insurance funds to pay 95%, out-of-Pocket 5%, except as otherwise provided in this way.
    23rd article integrated medical insurance parameter assured of outpatient basic medical costs and outpatient using place added medical insurance drug directory of drug, and clinic project of costs, by personal account paid; personal account insufficient paid of, its in medical insurance annual within over city Shang annual town workers average wage 10% above of outpatient basic medical costs, by basic medical insurance and manpower Fund paid 70%, personal since pay 30%. 24th medical insurance insured in-patient medical expenses paid by the basic medical insurance fund 90%, personal 10% pays.
    But the guarantor for retirees, the hospital's medical costs are covered by basic medical insurance funds to pay 95%, out-of-Pocket 5%, except as otherwise provided in this way.
    Hospital medical insurance insured outpatient medical expense except the 27th article.
    25th comprehensive health insurance insured clinics, because of their illness and by the municipal social security institutions or its authorized medical institutions after approval in the outpatient examination or treatment of large medical equipment, its costs are covered by the basic medical insurance fund 80%, personal pay 20%.
    Examination of large medical equipment and treatment programs established by the municipal social security institutions.
    26th article parameter assured for illness need, by city social security institutions approved, in do basic medical insurance clinic project in the of clinic Shi, using special medical with material or using price in 1000 Yuan above of one-time medical with material, and for artificial organ of installation or replacement, by basic medical insurance and manpower Fund by domestic universal type price paid 90%; no domestic universal type comparable price, by imports universal type price paid 50%.
    Range of special materials, artificial organs for medical use by the municipal social security institutions.
    27th insured outpatient hemodialysis of chronic renal failure, after an organ transplant anti-rejection drugs used in outpatient, outpatient chemotherapy and interventional therapy of malignant tumors, radiotherapy or radionuclide therapy, approved by the municipal social security institutions, the basic funds of basic medical insurance and pay medical 90%, personal 10% pays.
    Range determined by the municipal social security institutions for organ transplants. 28th article parameter assured each medical insurance annual from basic medical insurance and manpower Fund paid of highest limit not over city Shang annual town workers years average of 4 times times, and and continuous parameter insurance time linked, specific standard for: (a) continuous parameter insurance time discontent half of, basic medical insurance and manpower Fund paid highest limit for city Shang annual town workers years average of 0.5 times times; (ii) continuous parameter insurance time full half discontent 1 years of, Basic medical insurance and manpower Fund paid highest limit for city Shang annual town workers years average of 1 time times; (three) continuous parameter insurance time full 1 years discontent 2 years of, basic medical insurance and manpower Fund paid highest limit for city Shang annual town workers years average of twice times; (four) continuous parameter insurance time full 2 years discontent 3 years of, basic medical insurance and manpower Fund paid highest limit for city Shang annual town workers years average of 3 times times; (five) continuous parameter insurance time full 3 years above of,
    Basic medical insurance fund, last year, capped 4 times times the average annual wage for urban workers.
    Article 29th local supplementary medical insurance of an insured person, local supplementary medical insurance fund and pay the following 85%, out-of-Pocket 15%: (a)-maximum amount of basic medical insurance funds to pay basic medical expenses, (ii) use of supplementary medical insurance drug list in hospital prescribed pharmaceuticals and local supplementary medical insurance costs of diagnosis and treatment projects.
    30th article place added medical insurance of parameter assured, each medical insurance annual from place added medical insurance fund in the paid medical with of highest limit and continuous participate in basic medical insurance of time linked, specific standard for: (a) continuous parameter insurance time full half discontent 1 years of, place added medical insurance fund paid medical with of highest limit for 50,000 yuan; (ii) continuous parameter insurance time full 1 years discontent 2 years of, place added medical insurance fund paid medical with of highest limit for 100,000 yuan;
    (C) continuously insured time of 2 years and 3 years of age, and supplementary medical insurance pays a maximum of 150,000 yuan (iv) completed 3 years of continuous insurance, supplementary medical insurance pays a maximum of 200,000 yuan.
    31st birth perinatal health insurance insured checking, hospital childbirth, post-natal visits, family planning surgery basic medical expenses (excluding infant costs) by reproductive health insurance fund.
    Article 32nd insured meet the discharge standard, designated medical institutions confirmed the discharge is not discharged, the hospital confirmed discharge date of all medical costs paid by the individual.
    Appointed medical institutions of insured hospital and a dispute can be designated medical institutions confirmed its application within 3 working days from the date of discharge from hospital for identification, social security institutions. Social insurance institution shall, on receiving the application, later commissioned by the Committee of experts on medical insurance identification and self-insured application made within 7 working days from the date of conclusion.
    Health insurance expert conclusions of the Committee of experts to determine the discharge date for discharge.
    Article 33rd basic medical insurance, supplementary medical insurance and maternity health care beyond the scope of medical services by insured persons pay.
    Individual account accumulation up to 2 months, last year average monthly wage for urban workers, the excess can be used at designated medical institutions to pay clinic pays medical costs, supplementary medical expenses, or appointed retail drugstores to buy basic health insurance drug list and supplementary medical insurance drug list within the scope of non-prescription drugs.
    Article 34th human health of insured objects, their medical expenses are the basic medical insurance and place within the scope of supplementary medical insurance, paid for by the municipal social security institutions in accordance with the regulations; more than part of the solution, according to the relevant provisions of the municipal government.
    Article 35th of an insured person for work-related injuries and occupational diseases medical expenses, in accordance with the relevant provisions of the workers ' compensation insurance.
    Article 36th insured from leaving the city, social insurance institutions, where the personal account balance into their account; no corresponding local bodies, a one-time reimbursement for myself.
    Death of the insured individual account balance is paid to the heirs without heirs, to basic medical insurance funds.
    37th insured business trip, to visit relatives in China (excluding Hong Kong, Macao and Taiwan regions, the same below) other city emergency hospital, or approved by the municipal social security institutions referring to the other city hospital, basic medical care and local supplementary medical expenses incurred, according to the relevant provisions in these procedures the audit claims.
    Long-term presence in other cities, household, jobs in the insured or insured retirement living in other cities, should be submitted to the municipal social security institutions for the record, their places of work or residence of basic hospital care and local supplementary medical expenses, according to the relevant provisions in these procedures the audit claims.
    Insured in other cities of the country for medical treatment in outpatient medical expenses can be deducted from his personal account.
    Article 38th insured business trip, visiting relatives in foreign countries or Hong Kong, Macao and Taiwan areas during the emergency hospitalization, according to the municipal hospital to pay standard health insurance benefits. 39th article parameter assured has following case one of of, not enjoy this approach provides of medical insurance treatment: (a) itself to domestic other city, or Hong Kong, and o, and Taiwan area, or abroad diagnosis and treatment of; (ii) itself to city non-Sentinel medical institutions medical of, but has endanger life signs must near rescue of except; (three) since purchased drug of, but 33rd article second paragraph provides of case except; (four) for traffic accident, and medical accident or other accident caused hurt of; (five) for suicide, and self-harm, and self-mutilation, and alcohol, and
    Fight or I violations resulting in injury (vi) cause harm due to other violations of and (seven) others at the national, provincial and municipal regulations. 40th article parameter assured using following clinic project and medical with material, not enjoy this approach provides of medical insurance treatment: (a) registered, and hospital outside consultation, and special medical service, service project; (ii) beauty, and non-function sex cosmetic, and health experience, and medical advisory, and prevention health, non-disease treatment project; (three) Positron launches fault scan (PET), and photon knife, non-basic medical insurance clinic project; (four) non-basic medical insurance paid of one-time medical with material; (five) glasses, and denture, and
    Hearing aids, rehabilitation sex apparatus; (six) various organ or organization transplant of organ source or organization source; (seven) except kidney, and bone marrow, and corneal, transplant outside of other organ or organization transplant; (eight) qigong therapy, and magnetic, auxiliary sex treatment project; (nine) various not Yu (pregnancy) syndrome, and sex function obstacles of clinic project; (10) various research sex, and clinical validation sex of clinic project; (11) national, and province, and city about provides not claims of other clinic project.
    The clinics listed in the preceding paragraph project and the specific scope of medical materials stipulated by the municipal social security institutions, and social health insurance needs and medical technology development accordingly.
    The fourth chapter health insurance medical institutions and appointed retail drugstores 41st social medical healthcare institutions, management of appointed retail drugstores.
    Municipal social security institutions, in conjunction with health, drug administration departments according to the relevant regulations of the State in the city designated medical institutions, qualifications of appointed retail drugstores approach. 42nd of municipal social security institutions on the basis of unified planning, rational distribution, convenient medical care, taking into account principles of needs, encourage competition, and determining the designated medical institutions, appointed retail drugstores.

    State-owned medical institutions by the municipal social security institutions selected to determine the designated medical institutions shall not refuse other designated medical institutions, the municipal social security institutions determined in consultation with medical institutions.
    Social insurance institution should sign agreements with designated medical institutions.
    Article 43rd designated medical institutions should adhere to the "due to illness and treatment, reasonable examination, rational drug use, reasonable treatment" principle to the insured person in accordance with the provisions of these measures and the agreement to provide quality, efficient and affordable medical services.
    44th designated medical institutions shall set up medical and medicine separate accounting and management systems, standardize medical behaviors and reduce the insured pays costs as a proportion of total medical costs, reduce the financial burden on insured persons.
    45th medical institutions, appointed retail drugstores should establish internal management system in conformity with medical insurance system.
    46th designated medical institutions should comply with the basic standards of health care facilities require more than 80% health services; designated medical institutions and appointed retail drugstores should have basic medical insurance drug list and local 80% per cent of supplementary health insurance drug list medicines.
    47th designated medical institutions and appointed retail drugstores should strictly implement the relevant Government medical fees and price regulations, and to the public.
    Designated medical institutions shall provide to the insured outpatient or hospital daily fee details.
    48th medical institutions providing medical services should perform basic medical insurance drug list, medical projects, health services standards and local supplementary medical insurance drug list, medical items and other relevant regulations.
    Designated medical institutions for the insured person uses other than those specified in the preceding paragraph medicines, medical items, medical services shall obtain the consent of the insured.
    49th insured when medical insurance documents to the designated retail pharmacy to buy medicine, designated retail pharmacy shall comply with the following provisions: (a) the sale of non-prescription drugs should be consistent with the provisions of the second paragraph of this article 33rd; (b) prescription for selling prescription drugs shall be designated medical institutions; (c) the medical insurance billing. 50th when checking and monitoring, social security institutions, medical institutions, appointed retail drugstores have an obligation to provide the relevant information and a list of costs.
    Does not offer or provide incomplete, the municipal social security institutions should refuse to pay the corresponding fees. Fifth chapter medical with settlement 51st article parameter assured medical or purchase drug by occurred of meet basic medical insurance, and place added medical insurance or birth medical insurance provides of medical costs, by parameter assured of medical insurance documents according to following provides handle: (a) belongs to basic medical insurance and manpower Fund, and place added medical insurance fund or birth medical insurance fund paid of, Sentinel medical institutions should truthfully meter account; (ii) belongs to personal account paid of,
    Designated medical institutions or appointed retail drugstores should buckle from the insured person's individual account, not enough to pay for personal accounts should be directly charged to the insured person.
    Designated medical institutions, appointed retail drugstores on the insured doctor or buy medicines not part of basic medical insurance, supplementary medical insurance or maternity medical insurance medical expenses shall be directly charged to the insured person.
    52nd medical services insurance settlement can take billing, service units, such as clearing, clearing or settlement in advance the total amount.
    Municipal organization of social insurance according to the fixed-point medical institutions of different categories and actual situation of settlement and municipal social security institutions and clearly designated medical institutions signed the agreement.
    53rd in accordance with the conditions specified in article 23rd, by the basic medical insurance fund pay clinic fees, insured medical insurance in the next year, by out-patient medical records, expense list, the original fee receipt to municipal social security institution to reimburse outpatient costs.
    54th insured in other cities of the country emergency Department approved for referral to other cities in China and hospital medical expenses, hospital diagnosis certificate or medical records, hospital discharge summary, list of the cost breakdown and the original fee receipt and other relevant information, according to examine claims.
    Long-term presence of domestic work in other cities, household registration, the insured or insured persons residing in different places after retirement, local medical insurance appointed hospitals of basic medical expenses and local supplementary medical expenses, diagnosis certificate or relevant medical records, hospital discharge summary, list of the cost breakdown and the original fee receipt and other relevant information, according to examine claims.
    Insured abroad or to Hong Kong, Macao and Taiwan areas during the emergency hospital, unit certificates, passport or Hong Kong, Macao and special passes, medical records or discharge summaries, cost details, and the original charging document, social security institutions, to review claims.
    55th article of the sixth chapter of health insurance supervision, established by the Government representatives, representatives of companies, trade union representatives and other social security supervisory body composed of representatives of the community.
    Social security supervisory agencies to health insurance laws and regulations, implementation of regulations and supervision payments, use and management of the Fund.
    56th all units and individuals have the right to report designated medical institutions, appointed retail drugstores, the insured and the municipal social insurance law, violations that agency staff.
    Municipal social security institutions shall give rewards to informants, incentives to the verified amount of illegal or irregular 20% by the municipal social insurance agency paid from the funds of basic medical insurance.
    57th medical insurance, social insurance institutions, and the insured have the right to query the unit or medical insurance fees, salary and benefits, and so on.
    58th insurance unit every six months of health insurance premiums should be paid to the employee is published.
    59th of municipal audit institutions every year to conduct regular audits of financial revenue and expenditure of the health insurance fund, the audit results should be reported to the social insurance supervisory authorities.
    Municipal Fund of social insurance institution shall establish and improve the medical insurance finance system and internal audit system.
    60th health administrative departments at all levels should strengthen supervision and administration of designated medical institutions, appointed medical institutions of Medicare provisions into the implementation of the integrated management of content, and linked to the premier goal responsibility system.
    61st of municipal price Administration Department should strengthen the designated medical institutions appointed retail drugstores and the implementation of national, provincial, municipal and drug price policy of medical service supervision.
    Pharmaceutical supervisory and administrative departments should strengthen fixed-point medical institutions of appointed retail drugstores and drug quality supervision.
    62nd of municipal social security institutions, in conjunction with health, price, medicines and other related departments, regular or ad hoc basis to designated medical institutions and joint supervision and inspection appointed retail drugstores.
    When the 63rd of municipal social security institutions in the checked, units under inspection shall faithfully reflect the situation, and provide the requested information the units under inspection shall not refuse to check shall not misrepresent, conceal.
    Municipal social insurance institutions insurance companies pay for inspections, may request units under inspection and payment of health insurance premiums relating to the employment, payroll, financial statements and other information; records, sound recording, video recording, photography and copy the relevant information, but it should be keep secret for the units under inspection.
    64th of municipal social security agencies should be audited annually in Medicare fund raising, balance of payments, and using, to the public.
    65th article city social security institutions established medical insurance experts Committee, carried out following activities: (a) for city social security institutions according to this approach developed about policy provides advisory; (ii) for city social security institutions for medical insurance supervision check provides technical guidance, on supervision check in the occurred of medical difficult problem provides identification views; (three) on parameter assured and Sentinel medical institutions for discharged occurred of dispute for identification.
    Health insurance requirements for activities of the Committee of experts by the municipal social security institutions from a collection of medical insurance fund according to the ratio of not more than 0.1% extracts. 66th seventh chapter law responsibility an employer is not required to pay health insurance premiums and municipal social security institutions ordered to correct them.
    Late is still not correct, since the date of the order is not paid less or fined amount 10% to pay medical insurance premiums.
    The employer is not required to pay medical insurance does not pay; during the unpaid medical expenses paid by the employer in accordance with the measures provided.
    67th article parameter insurance units for this approach provides of parameter insurance object yiwai of personnel handle medical insurance of, the parameter assured of medical insurance relationship invalid, and on parameter insurance units sentenced 5000 Yuan above 10000 Yuan following of fine; on has occurred of medical insurance fund paid of costs, city social security institutions should to parameter insurance units recovered; party constitute crime of, by judicial organ law held criminal.
    68th in violation of these rules, do not handle registration of medical insurance, concealing the number of insured, refuses to provide the information or provide false information by the municipal social security institutions ordered to rectify; fails, depending on the seriousness, more than 2000 Yuan for insured units in charge of up to 5000 Yuan fine.
    Article 69th, social insurance institutions, hinder or obstruct the staff performing official duties according to law by the public security organs in accordance with the punishment constitutes a crime, shall be investigated for criminal responsibility by judicial organs.
    70th insured any of the following acts, municipal social insurance institution shall recover the social medical insurance costs that have been paid, and direct responsibility for health insurance fund payments 1 time penalty constitutes a crime, shall be investigated for criminal responsibility by judicial organs.
    (A) the documents lent to others for treatment of my medical insurance, (ii) medical history, prescriptions, costs of document fraud and overstated or falsely claimed. 71st medical institutions, appointed retail drugstores under medical care fixed-point medical institutions of insurance agreement of appointed retail drugstores or health insurance agreements, according to the agreement, social security institutions held accountable for breach of contract.

    72nd article Sentinel medical institutions has following behavior one of, caused medical insurance fund loss of, should compensation loss, and by city social security institutions sentenced 5000 Yuan above 20000 Yuan following of fine; plot serious of, suspended or canceled its Sentinel medical institutions qualification: (a) will non-parameter assured of medical costs by medical insurance fund paid of; (ii) will should by personal since pay of medical Yongji into medical insurance fund paid range of; (three) misappropriated others personal account of;
    (D) the insured will not meet hospital standards for hospital treatment, or arbitrary extension of insured hospital stays, subparagraph titular hospital, false medical records, billing, or without the consent of the insured income of over standard Ward (v) take other means to increase health insurance fund.
    Directly responsible for the provisions of the preceding paragraph, by the municipal social security institutions depending on the seriousness of a warning, the right to be criticized or lift their Medicare prescription.
    73rd appointed retail drugstores disobey 49th article, more than 1000 10000 Yuan by the municipal social security institutions the following fines in serious cases, suspend or cancel the qualification of appointed retail drugstores.
    74th designated medical institutions, appointed retail drugstores violating price regulations, the price Administration Department in accordance with the relevant provisions.
    Designated medical institutions, appointed retail drugstores under medicines regulations by the pharmaceutical supervisory and administrative department in accordance with the relevant provisions.
    75th of municipal social security institutions for abuse of power, negligence, malpractice, by their work units or departments concerned penalties in loss of health insurance fund shall bear liability constitutes a crime, shall be investigated for criminal responsibility by judicial organs.
    76th, made by the social security authorities, parties notice or the recovery of a notice, decision or medical insurance benefits is dissatisfied with a decision may apply for reconsideration or litigation.
    Workers ' organization is not required to pay health insurance premiums, or not in accordance with the means to reimburse unpaid health insurance premiums during the health-care costs, may make a complaint to the municipal social security institutions and relevant departments, or apply for arbitration to the arbitration body. On the eighth chapter supplementary articles article 77th Annual monthly wage for urban workers is subject to municipal Statistics Department announced.
    In this way, last year, the monthly salary for urban workers involved, by the first half of last year, monthly wage for urban workers, the calculation by the second half of last year, monthly wage for urban workers, the calculation.
    78th article of the municipal enterprises outside the city to set up branches, the Office staff, basic medical insurance, where the participating institutions.
    Employment of foreigners in this city and Hong Kong, Macao and Taiwan people's health insurance, according to the relevant State regulations.
    79th special difficulties due to late payment of health insurance premiums employers, can apply to the municipal organization of social insurance payment is approved the decision by the municipal social security institutions; authorized payment period shall not exceed 3 months.
    The insured due to large amount of out-of-Pocket medical expenses, causing living below the subsistence level in the city, may apply to the municipal organization of social insurance medical fee subsidy.
    Without the approval of the municipal social security institutions stopped paying medical insurance premiums, workers ' medical costs paid by the employer in accordance with the measures.
    80th of individual economic organizations to the municipal domicile in China with reference to these measures.
    81st Annual medical insurance from July 1 to June 30 next year.
    82nd civil service medical benefits, supplementary medical insurance and the specific measures shall be separately formulated by the City Government.
                                                                                                                  83rd these measures come into force on July 1, 2003.