Notice of the General Office of Beijing Municipal People’s Government on Printing and Distributing the Implementation Opinions on Establishing Beijing Disease Emergency Relief System (for Trial Implem
Beijing Zhengban Fa [2014] No.65
The people’s governments of the districts and counties, the commissions, offices and bureaus of the municipal government, and the municipal institutions:
"Implementation Opinions on Establishing Beijing Disease Emergency Relief System (Trial)" has been approved by the municipal government and is hereby issued to you, please conscientiously implement it in light of the actual situation.
General Office of Beijing Municipal People’s Government
December 31, 2014
Opinions on the establishment of Beijing disease emergency rescue system (for Trial Implementation)
In order to implement the spirit of the Guiding Opinions of the General Office of the State Council on Establishing the Emergency Relief System for Diseases (No.15 [2013] of the State Council), further improve the multi-level medical security system in this Municipality, and effectively solve the medical emergency security problems of a very small number of patients who are unidentified and unable to pay medical expenses, this implementation opinion is formulated in combination with the actual situation.
I. General requirements
(1) Work objectives. Through government financial investment and social donations, the municipal disease emergency rescue fund is raised to help patients who have acute and serious injuries and need first aid but whose identities are unclear or unable to pay the corresponding expenses, and to subsidize the medical expenses incurred in receiving emergency treatment, so as to encourage medical institutions to treat patients with acute and serious injuries in a timely and effective manner, effectively solve the practical difficulties of the people and promote social harmony and stability.
(2) Working principles. The disease emergency assistance system is a medical assistance guarantee policy established in this city for the disadvantaged groups, and it is an important supplement to the existing medical security system. It is necessary to adhere to the close connection between the disease emergency rescue system and other medical security systems, adhere to the combination of government-led and encouraging social charitable medical care and the use of third-party professional services, adhere to the combination of government financial input and encouraging social donations, and adhere to the combination of medical institutions undertaking emergency treatment obligations and giving financial subsidies according to law.
(3) Job requirements. All kinds of medical institutions at all levels in this Municipality should actively undertake the obligation of emergency treatment, and unconditionally treat patients with acute and critical injuries and those in need of emergency treatment in accordance with the Notice of the General Office of the National Health and Family Planning Commission on Printing and Distributing the Standards for Acute and Critical Injuries and Diagnostic and Therapeutic Norms (No.32 [2013] of the National Health Office), and shall not refuse, shirk or delay for any reason. Emergency treatment should adhere to the principle of timely, effective and reasonable, and treat diseases, check reasonably, use drugs rationally and treat reasonably; For patients who need to be referred in the process of treatment, they should be referred in time according to their condition and in accordance with the principle of proximity and rationality to ensure life safety.
II. Establishment, raising and management of disease emergency relief fund
(1) Establishment of the fund. The establishment of the Municipal Disease Emergency Relief Fund is mainly responsible for raising funds and paying emergency relief funds to medical institutions.
(2) Fund raising. City disease emergency rescue fund through financial investment and social donations and other channels to raise. The Municipal Finance Bureau shall incorporate the subsidy funds of the disease emergency relief fund into the fiscal budget, and incorporate the central special subsidy funds into the overall arrangement of the disease emergency relief fund. Encourage all sectors of society to donate to the disease emergency relief fund.
(3) Fund management. The Municipal Health and Family Planning Commission shall, jointly with the Municipal Finance Bureau, formulate measures for the supervision and management of fund handling management institutions, and select qualified charitable foundations, public welfare social organizations or institutions as fund handling management institutions in an open, fair and just manner, which will manage the funds in accordance with the principles of openness, transparency, professionalism and standardization.
Three, the application, examination and payment of disease emergency relief fund
(1) Fund application. After medical institutions implement emergency treatment for patients, patients are unable to pay for emergency treatment, but there is a clear responsible person or it can be solved through work-related injury insurance, urban basic medical insurance, new rural cooperative medical fund, medical assistance fund, social assistance fund for road traffic accidents, assistance fund for vagrants and beggars and other payment channels. Patients or medical institutions should first apply to the relevant responsible person or other payment channels. Without the above channels or after payment through the above channels, there is still a gap in expenses, and medical institutions may regularly apply for financial subsidies from the Municipal Disease Emergency Relief Fund according to regulations. When applying, the medical institution shall review and summarize the unrecoverable emergency treatment expenses and related materials, and submit the patient’s identity, treatment summary and diagnosis certificate, list of emergency treatment expenses, declaration and payment of other payment channels and other related certification materials.
(2) fund review. The municipal disease emergency relief fund management agency is responsible for accepting the application for emergency relief funds submitted by medical institutions, and reviewing the emergency treatment behavior and related expenses of medical institutions; With the assistance of the municipal human resources and social security, health and family planning, civil affairs, public security and other departments, carefully check whether patients have the ability to pay or have other payment channels, and whether other channels have paid the fees according to regulations and other relevant certification materials. Fund management agencies should establish and improve the system and mechanism, improve the rules and regulations, and hire experienced professionals to conduct key audits on medical behaviors and expenses.
(3) Fund payment. After the examination and approval of the fund management institution, it shall allocate subsidy funds to the medical institution applying for it within one month; The cumulative time from accepting the application to paying the subsidy or confirming that the subsidy will not be granted shall not exceed three months. For medical institutions with heavy emergency rescue tasks and great pressure on fund advance, the fund handling management institution can refer to the actual expenses incurred in the previous year, and allocate working capital to medical institutions in the form of pre-allocation at the beginning of the year, regular settlement and overpayment and underpayment. The disease emergency rescue fund shall not be used to pay the emergency treatment expenses of patients with verified identity and proven affordability.
Four, the supervision and management of disease emergency relief fund
The Municipal Health and Family Planning Commission and the Municipal Finance Bureau organized the establishment of the Disease Emergency Relief Fund Supervision and Management Committee, which was attended by representatives of relevant departments, deputies to the National People’s Congress, members of the Chinese People’s Political Consultative Conference, representatives of donors, representatives of news media and people from all walks of life, such as medical, financial and legal experts, to supervise the management and use of the fund, financial budget and final accounts and other major issues; Entrust a third-party professional organization to conduct an annual audit of the collection, management, use and balance of the disease emergency relief fund, and announce the audit results to the public and accept public supervision.
If the fund handling management institution fails to accept and review the application for funding subsidy in accordance with the regulations, or fails to timely allocate the subsidy funds in accordance with the regulations for no reason, the Municipal Health and Family Planning Commission shall, jointly with the Municipal Finance Bureau, give informed criticism, make rectification within a time limit until the fund handling management institution is replaced.
For medical institutions that cheat or cheat emergency relief funds, in addition to recovering subsidy funds from them, the Municipal Health and Family Planning Commission will severely deal with medical institutions and their directly responsible persons in accordance with relevant laws and regulations. For patients who cheat or cheat emergency relief funds, medical institutions and fund management agencies should promptly recover arrears from them and return the recovered funds to the disease emergency relief fund.
V. Organizational guarantee
In accordance with the principle of government organization and leadership, coordination and cooperation between departments, establish a joint meeting system of municipal disease emergency rescue, be responsible for studying and formulating relevant supporting policies and measures, and make overall plans to promote disease emergency rescue work. Members of the joint meeting include the Municipal Health and Family Planning Commission, the Municipal Finance Bureau, the Civil Affairs Bureau, the Municipal Public Security Bureau, the Municipal Human Resources and Social Security Bureau, the Municipal State Taxation Bureau, the Municipal Local Taxation Bureau and other departments, and the office is located in the Municipal Health and Family Planning Commission. All members of the joint meeting should strengthen coordination and cooperation in accordance with the division of responsibilities, form a joint effort, and ensure that the disease emergency rescue system is implemented. Attachment: Establishing the Division of Responsibilities of Beijing Disease Emergency Relief System Attachment: Establishing the Division of Responsibilities of Beijing Disease Emergency Relief System
Municipal Health and Family Planning Commission: responsible for taking the lead in formulating the subsidy standards for emergency disease relief, the norms and procedures for confirming the identity and payment ability of emergency disease relief objects, and the supervision and management measures for the management institutions of emergency disease relief funds. Assist the Municipal Finance Bureau to formulate measures for the supervision and management of the municipal disease emergency relief fund. In conjunction with the Municipal Finance Bureau, select and determine the fund handling management institutions, and supervise and guide them to carry out their business. Assist the fund management agency to review and confirm the identity or payment ability of relevant patients. Supervise medical institutions to perform emergency treatment obligations according to laws and regulations, and investigate and deal with illegal acts such as medical institutions and their staff defrauding and taking subsidies.
Municipal Finance Bureau: responsible for taking the lead in formulating the measures for the supervision and management of municipal disease emergency relief funds, and determining the fund raising scale, subsidy methods and standards. To assist the Municipal Health and Family Planning Commission in formulating the subsidy standards for disease emergency relief and the measures for the supervision and administration of the management institutions of disease emergency relief funds. Assist the Municipal Health and Family Planning Commission in selecting and determining the fund handling management institution, and supervise and guide its business. Responsible for the government investment in the city’s disease emergency relief fund, arrange the operating expenses of the fund management agency according to the way the government purchases services, and guide and supervise the use and management of the fund.
Civil Affairs Bureau: responsible for assisting the Municipal Health and Family Planning Commission in formulating the norms and procedures for confirming the identity and payment ability of the emergency aid recipients. Assist medical institutions and fund management agencies to review and confirm the identity and payment ability of relevant patients. Guide the district and county civil affairs departments to do a good job in allocating medical assistance funds for social assistance objects and assistance funds for vagrants and beggars within their respective jurisdictions.
Municipal Public Security Bureau: responsible for assisting the Municipal Health and Family Planning Commission in formulating the norms and procedures for confirming the identity and payment ability of emergency relief objects. Assist medical institutions and fund management agencies to review and confirm the identity and payment ability of relevant patients. Supervise and coordinate the allocation of social assistance funds for road traffic accidents.
Municipal Bureau of Human Resources and Social Security: responsible for assisting the Municipal Health and Family Planning Commission in formulating the norms and procedures for confirming the identity and payment ability of emergency relief objects. Assist medical institutions and fund management agencies to review and confirm the identity and payment ability of relevant patients. Supervise the social insurance management institutions to pay the emergency treatment expenses of insured patients.
Municipal State Taxation Bureau and Municipal Local Taxation Bureau: responsible for implementing the preferential tax policies for disease emergency relief funds to accept social donations in accordance with relevant state regulations.
District and county governments: organize district and county health and family planning departments to assist medical institutions and fund management agencies to verify whether the rescued object belongs to the new rural cooperative medical system and pay the emergency treatment expenses payable by the new rural cooperative medical system according to regulations; Strengthen the daily supervision of medical institutions to fulfill their obligations of emergency treatment.
Medical institutions: All kinds of medical institutions at all levels in this city should establish and improve the organization and leadership mechanism, designate relevant departments to be responsible for the daily management of disease emergency rescue, undertake emergency rescue obligations in accordance with relevant state regulations, and organize emergency rescue work. Public medical institutions should improve the internal control mechanism, and write off part of the first-aid arrears incurred by the aid recipients by charging bad debt reserves. Encourage non-public medical institutions to take the initiative to write off the first-aid expenses of emergency relief objects.
Fund handling and management institution: responsible for accepting and reviewing the application for financial subsidies and related certification materials submitted by medical institutions, and checking the basic information such as the identity, payment ability and other payment channels of arrears patients with the assistance of relevant departments; Timely disbursement of subsidy funds to medical institutions according to regulations; Pre-allocate working capital to medical institutions that often undertake first aid work; Recover emergency treatment expenses from patients who have the ability to pay or other payment channels; To recover the emergency relief funds that have been defrauded or taken from the medical institutions with outstanding problems; Do a good job in raising social donation funds and other management work.