医保基金收支管理的若干法律思考

On Managing the Hospitalization Insurance Funds Based on Law

医疗保险制度的运行是以基金的收支为纽带,基金收支关涉企业、职工、医保机构、医疗机构和各级政府的切身利益。目前从法律视角对医保基金收支进行研究十分欠缺,以致于现行医保制度实施中有关基金收入与结算支付的法律关系仍然处于相当混沌的状态。本文分析了医保基金筹集、医保基金支付结算及医保基金管理的法律关系,界定了医保基金收付中各个主体之间的权利义务关系。

The run of the hospitalization insurance system is connected with funds.Funds expenditure connects the benefits with enterprise,officers and organization of the medical insurance and all levels government.It is urgent to study the expenditure of the hospitalization insurance funds.The current hospitalization insurance system is in chaos in the relations with the law of the funds and balance.This paper analyzes the relations of the hospitalization insurance funds,payment and hospitalization insurance management,and defines the relations between right and obligation of main body in hospitalization insurance funds payments.