Other relevant departments of the people's governments at or above the county level shall be responsible for the supervision and administration of basic medical insurance within the scope of their respective duties. Sixth basic medical insurance agencies (hereinafter referred to as agencies) in accordance with laws, regulations, rules and responsibilities stipulated by the people's government at the same level is responsible for the basic medical insurance services. Chapter II Insurance and Payment Article 7 Full-time employees of government organs, enterprises, institutions, social organizations, private non-enterprise units and individual industrial and commercial households (hereinafter referred to as employers) shall participate in the basic medical insurance for employees according to law. Employers and employees shall pay basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with the relevant provisions of the state and the province.
Urban and rural residents participate in the basic medical insurance for urban and rural residents in accordance with the relevant provisions of the state and the province.
Participants in the basic medical insurance for employees and the basic medical insurance for urban and rural residents are hereinafter referred to as the insured. Eighth people who have participated in the basic medical insurance for employees will no longer participate in the basic medical insurance for urban and rural residents during the insurance period.
Urban and rural residents whose residence is inconsistent with their household registration can choose one place to participate in the basic medical insurance for urban and rural residents; Those who have participated in the basic medical insurance for urban and rural residents in one place shall not be insured in another place for the same period. Article 9 The employing unit shall strengthen the management and service of its employees who participate in the basic medical insurance, and timely and accurately provide the medical insurance agencies with relevant certification materials of the insured. Tenth agencies shall, in accordance with the relevant provisions of the state and the province, verify the payment base of the employer and the insured. The collection agency of basic medical insurance premium shall collect the basic medical insurance premium of employees in full and on time, and shall not postpone or reduce the payment except for legal reasons.
The basic medical insurance fund shall be managed by special financial accounts, which shall be used for special purposes, and no unit or individual may occupy or misappropriate it. Eleventh employers in the insurance payment, shall not have the following acts:
(a) failing to go through the formalities of registration, payment or change of basic medical insurance for employees in accordance with the regulations;
(two) the financial accounting statements are untrue, concealing or underreporting the total wages of employees or the information of insured persons;
(three) issued a false certificate of labor and personnel relations;
(four) interception or misappropriation of the basic medical insurance premiums paid by the insured;
(5) Other illegal acts. Twelfth insured persons shall not forge household registration, student status, labor and personnel relations or use other people's information to participate in the basic medical insurance. Chapter III Service and Management Article 13 An agency shall sign a service agreement with qualified medical institutions and retail pharmacies on the principle of equality, voluntariness and consensus, and establish a medical expense settlement relationship. The agency shall report to the medical insurance administrative department at the same level for the record within 15 days after the signing of the agreement.
The administrative department of medical insurance shall establish a medical insurance service management system and extend the supervision of basic medical insurance to medical institutions and retail pharmacies (hereinafter referred to as agreed medical institutions and pharmacies). Fourteenth provincial medical insurance administrative departments shall formulate the management measures and service agreements of medical institutions and retail pharmacies. The service period agreed in the agreement shall not be less than 1 year. Article 15 Medical institutions and pharmacies under agreement shall establish and improve the basic medical insurance management system and information system, designate full-time personnel to be responsible for the daily work of the basic medical insurance, and provide medical and pharmaceutical services for the insured in accordance with the provisions and agreements of the basic medical insurance. Sixteenth medical institutions and their personnel to provide basic medical insurance medical services for the insured, shall comply with the following provisions:
(a) to verify the basic medical insurance certificate and identity documents;
(2) Providing standardized and reasonable medical services;
(three) the implementation of medical service price regulations;
(four) the implementation of the basic medical insurance drug list, medical service facilities directory management regulations;
(five) the implementation of the basic medical insurance fee settlement system;
(six) take the initiative to issue medical expenses documents and related materials;
(seven) other relevant provisions on the management of basic medical insurance.
Medical institutions and their personnel who use drugs and medical services beyond the scope of payment from the basic medical insurance fund shall explain to the insured or their families in advance and obtain their consent, except in special circumstances such as emergency and rescue.