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Bozhou City, Pilot Project of innovation in supervision of National Health Insurance Fund, was rated as "excellent"
Release date:2021-10-21  Source::亳州外事办  Views:223

        Recently, the National Medical Insurance Bureau issued a notice that our city was rated as “excellent” in the final evaluation of the pilot innovation pilot of the national medical insurance fund supervision method.
        In May 2019, our city was identified as a pilot city for innovation in supervision of national Medical Insurance Fund. Subsequently, the city's medical insurance system followed the trend, explored innovation, and steadily advanced, significant achievements have been made in the establishment of a full-time supervisory team, the joint management of departments, and the introduction of third parties, forming a “Bozhou Model” for the supervision of Health Insurance Funds. The State Council General Office “Government Affairs Exchange” introduces the intelligent construction of Bozhou Health Insurance Fund supervision. In July 2021, the centralized Seminar on the summary and evaluation of the pilot innovation of medical insurance fund supervision mode was held in Luzhou, Sichuan. After comprehensive deliberation by the expert group, our city was recognized as "excellent".
        In the past two years, our city has continuously enriched the fund supervision force,a full-time team of 68 people was formed, 404 middle-level and senior doctors were selected to form an expert database, 2878 assistants were identified, and 75 supervisors were selected to build a horizontal and vertical supervision network. In accordance with the principle of “Separation of management and administration”, commercial insurance companies are introduced through public bidding through the purchase of services by the government, and we have helped to participate in the supervision of the Health Insurance Fund and played a full role as a professional assistant. At the same time, the city has carefully built a whole chain intelligent monitoring system and took the lead in building an intelligent supervision platform covering advance warning, in-process control and post audit in the province. Fund supervision has moved forward from "fire-fighting" post audit to "preventive" advance warning and in-process control. In order to unite the joint efforts of department supervision, our city has formulated the cooperation mechanism of "three medical linkage",information sharing and joint law enforcement of medical insurance, discipline inspection and supervision, public security, market, health and other departments, so as to realize "multiple investigations, multiple shifts and multiple locations of one case" in fund supervision.

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