Article 1 According to the Civil Servant Law of People's Republic of China (PRC), the Notice of General Office of the State Council on Forwarding the Opinions of Ministry of Labor and Social Security and Ministry of Finance on Implementing National Civil Servants' Medicaid (Guo Ban Fa No.20037) and the Notice of General Office of the People's Government of Inner Mongolia Autonomous Region on Forwarding the Opinions of Ministry of Labor and Social Security and Ministry of Finance on Implementing National Civil Servants' Medicaid in Inner Mongolia Autonomous Region (Guo Ban Fa No.20012), the medical treatment of municipal civil servants is guaranteed.
Article 2 The principle of Medicaid
The level of Medicaid for municipal civil servants should be compatible with the local economic development level and financial affordability; In order to ensure the medical security level of municipal civil servants, the raising standard should be gradually improved; Medicaid funds are used as a whole.
Article 3 The scope of Medicaid
(a) the implementation of the "People's Republic of China (PRC) Civil Service Law" of the municipal authorities and retirees;
(two) the staff and retirees of government agencies and institutions approved to be included in the management of the civil service law;
(three) units and personnel that have been included in the civil service Medicaid before the implementation of these measures.
(four) units and personnel approved by the administrative department of medical insurance to implement Medicaid for civil servants.
Article 4 The raising and use of Medicaid funds
(a) the financing standard of Medicaid funds is reasonably determined according to the actual consumption level of Medicaid personnel at the city level, the financing level of basic medical insurance and the financial affordability. The funding standard of Medicaid for civil servants at the city level is 2.6% of the total wages of employees.
(two) Medicaid funds for civil servants are raised according to the determined financing standards and included in the fiscal budget of the city at the corresponding level. By the Municipal Finance Bureau through the social security fund financial accounts to the Municipal Medical Insurance Fund Management Bureau (hereinafter referred to as the Medical Insurance Bureau) appropriated.
(three) Medicaid for civil servants to subsidize the following expenses:
1. conforms to the basic medical insurance drugs, diagnosis and treatment items, medical service scope and payment standards, and exceeds the basic medical insurance pooling fund and large medical insurance.
Pay the sum of medical expenses above the limit of hospitalization (including comparative hospitalization).
2 metre above (including metre) leading cadres in accordance with the provisions of the outpatient medical expenses; Professional and technical personnel who enjoy the positive and advanced treatment shall have a comprehensive physical examination, and the medical expenses shall be borne by themselves; Cultural Revolution disabled medical staff to participate in the basic medical insurance units, pay more 1 10,000 yuan medical insurance nursing fees; The expenses incurred by civil servants who enjoy Medicaid to have a health examination every two years.
3 municipal civil servants due to work-related injuries, occupational diseases, maternity medical expenses.
4 city level civil servants to participate in large medical insurance fees should be paid.
(four) the civil service Medicaid funds and the basic medical insurance fund are accounted for separately, and the funds are earmarked for special purposes, and are strictly managed according to the principle of balance of payments.
Article 5 Medicaid standards
(1) The medical expenses stipulated in these Measures conform to the provisions of basic medical insurance drugs, diagnosis and treatment items, medical service scope and payment standards, and the expenses shall be subsidized according to the following standards:
1. In a natural year, 90% of the hospitalization (including comparative hospitalization) medical expenses that exceed the sum of the maximum payment limits of the basic medical insurance pooling fund and the large medical insurance fund (330,000 yuan) will be subsidized.
2. Before the start of the industrial injury insurance system in government agencies and institutions, the industrial injury and occupational disease subsidies enjoyed by municipal civil servants include treatment, rehabilitation and assistive devices.
The reimbursement rate of medical expenses is 100%.
3. The subsidies enjoyed by municipal civil servants in childbirth (including induced labor and abortion) include hospitalization expenses (reimbursement ratio is 100%) and one-time maternity nutrition subsidies, among which one-time maternity nutrition subsidies are paid according to the standards of abortion in 400 yuan, natural delivery in 700 yuan, cesarean section, dystocia and multiple births 1300 yuan. Do not enjoy the maternity allowance and holiday allowance for male employees.
4. Leading cadres at or above the municipal deputy department level (including the deputy department level) meet the requirements.
The prescribed outpatient medical expenses shall be subsidized according to the proportion of 90%.
(two) to pay large medical insurance premiums for civil servants at the city level, and the standard is per
Per person per year 100 yuan.
Article 6 Management and supervision of Medicaid work
(a) the municipal medical insurance administrative department shall undertake the management functions of municipal civil servants' Medicaid, and strengthen the assessment and supervision of the specific handling work.
And management.
(two) the Municipal Finance Bureau is responsible for the allocation of Medicaid funds, and strengthen the management of financial accounts, supervision and inspection of the allocation and use of subsidy funds.
(III) The Municipal Medical Insurance Bureau is responsible for the handling of Medicaid for civil servants at the city level, strictly implement the relevant provisions of Medicaid for civil servants, establish and improve the management systems of budget and final accounts, financial accounting and internal audit, and do a good job in the policy convergence and management of Medicaid for civil servants and the basic medical insurance system. It is necessary to facilitate civil servants to seek medical treatment and settle related expenses in time, strictly control expenses according to regulations, strive to improve the level of management services, and ensure the implementation of Medicaid for municipal civil servants.
(four) take the initiative to accept the audit of civil servants' Medicaid funds by the audit department.
Seventh flag areas may formulate their own supplementary measures for civil servants' medical care with reference to these measures.
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Article 8 These Measures shall come into force as of the date of promulgation.