Office: 08 13-5 153004
Medical supervision and management unit: 08 13-5 153007.
Financial unit of the fund: 0813-5153011
Medical audit unit: 0813-5155991.
Urban and rural residents insurance management unit: 0813-5153010.
Management unit of medical treatment in different places: 08 13-5 153008.
Work-related injury maternity management unit: 08 13-5 155990.
Integrated Information Unit: 08 13-5 153006
Archives service management unit: 08 13-5 155993.
The National Health Insurance Bureau implements the principles, policies and decision-making arrangements of the CPC Central Committee on medical security work, and adheres to and strengthens the centralized and unified leadership of the Party on medical security work in the process of performing its duties. The main responsibilities are:
(1) Drafting laws, regulations, policies, plans and standards for medical insurance, maternity insurance, medical assistance and other medical security systems, formulating departmental rules and organizing their implementation.
(two) to organize the formulation and implementation of measures for the supervision and management of medical insurance funds, establish and improve the safety prevention and control mechanism of medical insurance funds, and promote the reform of payment methods of medical insurance funds.
(three) to organize the formulation of medical insurance financing and treatment policies, improve the dynamic adjustment and regional adjustment and balance mechanism, coordinate the treatment standards of urban and rural medical insurance, and establish and improve the treatment adjustment mechanism suitable for the financing level. Organize the formulation and implementation of long-term care insurance system reform plan.
(four) to organize the formulation of drugs, medical consumables, medical services, medical service facilities and other urban and rural unified medical insurance catalogue and payment standards. To establish a dynamic adjustment mechanism, formulate the negotiation rules for medical insurance catalogue access and organize their implementation.
(5) Organizing the formulation of policies on the prices of medicines and medical consumables, medical service items and charges for medical service facilities, establishing a mechanism for reasonably determining and dynamically adjusting the price of medical services paid by medical insurance, promoting the establishment of a market-led social medical service price formation mechanism, and establishing a price information monitoring and information release system.
(six) to formulate bidding policies for drugs and medical consumables and supervise their implementation, and guide the construction of bidding platforms for drugs and medical consumables.
(VII) To formulate agreements and payment management measures for designated medical institutions and organize their implementation, establish and improve the credit evaluation system and information disclosure system of medical insurance, supervise and manage medical service behaviors and medical expenses incorporated into medical insurance coverage, and investigate and deal with illegal acts in the field of medical insurance according to law.
(eight) responsible for medical security management, public service system and information construction. Organize the formulation and improvement of policies on medical treatment management and expense settlement in different places. Establish and improve the transfer and connection system of medical security relations. Carry out international cooperation and exchanges in the field of medical security.
(nine) to complete other tasks assigned by the CPC Central Committee and the State Council.
(10) functional transformation. The National Medical Insurance Bureau should improve the unified basic medical insurance system and serious illness insurance system for urban and rural residents, establish and improve a multi-level medical security system covering the whole people and coordinating urban and rural areas, continuously improve the level of medical security, ensure the rational use, safety and controllability of medical insurance funds, and promote the reform of "three medical linkages" in medical care, medical insurance and medicine to better protect the medical needs of the people and reduce the burden of medical expenses.
(11) Division of responsibilities with the National Health and Wellness Commission. National Health Commission, the State Medical Insurance Bureau and other departments have strengthened the system and policy convergence in medical care, medical insurance and medicine, established communication and consultation mechanisms, and jointly promoted reforms to improve the utilization efficiency of medical resources and the level of medical security.