议我国“一法两规”下的医疗保险社会治理架构

The Legal Construction of Medical Insurance under the "One Law and Two Regulations" in China

党的十九大报告提出"深化依法治国实践"。在社会保险法和国务院及人社部关于智能审核与支付方式改革文件"一法两规"的引导下,我国正在形成医疗保险法治的雏形,这是我国社会治理的突破,是实现依法治国目标的重要举措。本文将描述我国"医疗服务协议下的信息共享与激励相容"的医疗保险法治架构,以及挑战和措施。

The report of the 19th National Congress of the CPC put forward “deepening the practice of governing the country according to the law”. Guided by the “Social Security Law” and the regulations on “intelligent audit of medical insurance” and “medical insurance payment method reform”, the embryonic form of the medical service governance mechanism in China is establishing. This is our country’s breakthrough in social governance and an important measure to achieve the goal of governing the country according to the law. This paper describes the rule of law framework, the challenges, the measures and the future social progress in China under condition of “information sharing and incentive compatibility for medical services agreements”.