Huang Huabo: Promoting a new leap in fund supervision

The new situation also lies in the continuous strengthening of the foundation of fund supervision.
The first is political guarantee to orient the rudder.
General Secretary Xi Jinping gave instructions and instructions on many occasions, and the Central Deep Reform Commission made special studies to make decisions and arrangements, forming a strong political guarantee for fund supervision in the future, which played an important role in cohesiveness.
The second is the accelerated consolidation of the legal foundation.
The "Regulations on the Supervision and Administration of the Use of Medical Security Funds" have been promulgated, and relevant interpretations, implementation rules, administrative disposal standards and other norms and standards are being expedited.
The third is the continuous improvement of various systems.
Various supervision and inspection systems such as daily inspections, unannounced inspections, key inspections, intelligent monitoring, and government-purchased services have been gradually improved, and the atmosphere of full coverage, no dead ends, re-investigation and strict deterrence continues to strengthen.
The fourth is to lay a solid foundation for capacity guarantee.
More than one-third of the provinces across the country have established full-time fund supervision institutions, and supervisory personnel and capabilities have been continuously enhanced.

Medical security is an important system for people's livelihood, and fund supervision is an important guarantee for the smooth operation of this system.

Due to the recognized high moral hazard in the medical insurance field and the asymmetry of information in the medical field, it is even more important to strengthen fund supervision.
General Secretary Xi Jinping has repeatedly emphasized that the medical insurance fund is the "life-saving money" and "life-saving money" of the people.

1.

Based on a new stage

Since the establishment of the National Medical Insurance Administration in 2018, the national medical insurance system has taken fund supervision as the primary task in accordance with the decisions and deployment of the Party Central Committee and the State Council, strengthened daily supervision, accelerated the rule of law and system construction, promoted reform and innovation, and made significant progress in stages.

Compared with the initial establishment of the National Medical Insurance Administration three years ago, the institutional environment, legal environment, institutional environment, public opinion environment, and social atmosphere of fund supervision have undergone major changes.
These changes must be fully understood to enhance confidence and initiative.

(1) The top-level design is basically completed.

It is embodied in two important documents passed by the two central deep reform committees.
The first is the 11th meeting of the Central Committee for Comprehensive Deepening Reform.

(2) A breakthrough has been made in the construction of the rule of law.

On December 9, 2020, the State Council executive meeting reviewed and approved the "Regulations on the Supervision and Administration of the Use of Medical Security Funds", which was signed by Premier Li Keqiang on January 15, 2021, and implemented on May 1.
This is my country's first specialized administrative regulation in the field of medical insurance, and it is also the first administrative regulation in the field of medical insurance fund supervision.

(3) Daily supervision and deterrence have been strengthened.

The National Medical Insurance Bureau has organized a nationwide special management campaign against fraudulent insurance for three consecutive years, serving as an important starting point for combating fraudulent insurance.
Through special governance, the whole country has achieved full coverage of the annual supervision and inspection of the two designated institutions.

(4) Continued efforts in comprehensive supervision.

At the beginning of the establishment of the National Medical Insurance Administration in 2018, it launched a special action jointly with the National Health Commission, the Ministry of Public Security, and the State Drug Administration.
According to the work deployment of reforming and improving the comprehensive supervision system of the medical and health industry, comprehensive supervision and inspection will be carried out jointly with relevant ministries and commissions.

(5) Social supervision has gradually become an atmosphere.

It is prominently manifested in three aspects: First, the establishment of a reward system for reporting.
In November 2018, the National Medical Insurance Administration and the Ministry of Finance issued the “Interim Measures for Reporting and Rewarding of Fraudulent Obtaining of Medical Security Funds”, established a national hotline for combating fraudulent insurance reports and complaints, and subsequently opened letters and visits, websites, WeChat public accounts, etc.

2.

Grasp the new situation

The new situation first lies in the general trend of domestic and international economic and social development.
From a domestic perspective, the Fifth Plenary Session of the 19th Central Committee has carried out an overall design and systematic plan for the national economic and social development during the "14th Five-Year Plan" period and until 2035.
It must be based on the new development stage, implement the new development concept, and build a new development pattern.
Promote high-quality development.
From an international perspective, the world is undergoing major changes unseen in a century.
The comparison of systems in the economic and social fields, and international competition are also intensifying.
The prevention and control of the new crown epidemic this time demonstrated the superiority of the socialist system and strengthened the "four self-confidence" of the people.
As an important component of the socialist system with Chinese characteristics, the medical insurance department took the initiative to implement targeted measures such as "two guarantees" and "five offices", which played an important role in enhancing the people's confidence in the medical security system with Chinese characteristics and further The advancement of the reform of the medical insurance fund supervision system and law enforcement system has laid the foundation.

The new situation also lies in the continuous strengthening of the foundation of fund supervision.
The first is political guarantee to orient the rudder.
General Secretary Xi Jinping gave instructions and instructions on many occasions, and the Central Deep Reform Commission made special studies to make decisions and arrangements, forming a strong political guarantee for fund supervision in the future, which played an important role in cohesiveness.
The second is the accelerated consolidation of the legal foundation.
The "Regulations on the Supervision and Administration of the Use of Medical Security Funds" have been promulgated, and relevant interpretations, implementation rules, administrative disposal standards and other norms and standards are being expedited.
The third is the continuous improvement of various systems.
Various supervision and inspection systems such as daily inspections, unannounced inspections, key inspections, intelligent monitoring, and government-purchased services have been gradually improved, and the atmosphere of full coverage, no dead ends, re-investigation and strict deterrence continues to strengthen.
The fourth is to lay a solid foundation for capacity guarantee.
More than one-third of the provinces across the country have established full-time fund supervision institutions, and supervisory personnel and capabilities have been continuously enhanced.

The new situation also lies in new challenges and new risks.
From the external environment, the new crown pneumonia epidemic has brought a huge and far-reaching impact on the economic and social development of the world.
Actively respond to the normalized development of the epidemic, and continue to guard the "life-saving money" of the people.
This is the fund supervision work must face The real problem.
At the same time, the accelerated development of new service formats such as the acceleration of aging, the participation of personnel in new formats, and the "Internet + medicine", which pose new challenges to fund security and supervision.

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