大连市加强医保基金行政监管的实践与思考

The Practice and Thinking on Strengthening the Administrative Supervision of Medical Insurance Fund in Dalian

《中共中央国务院关于深化医疗保障制度改革的意见》明确要求"改革完善医保基金监管体制".大连市创新医保行政监管体制、强化基金行政监管,取得了阶段性成效.但在基金监管中,相关法律缺失、行政监管与协议管理权责需要进一步分清、监管能力和专业人力资源不足等问题依然存在.对此,应加快医保基金监管法律建设,进一步完善医保基金监管体制,分清行政监管与协议管理权责,培养监管专业人才,提高监管能力.

The opinion on Deepening the Reform of Healthcare Security System clearly requires"reform and improve the supervision system of medical insurance fund".Dalian innovated and strengthened the administrative supervision system of medical insurance,and achieved phased results.However,in the fund supervision,there are still some problems,such as the lack of relevant laws,the need to further distinguish the rights and responsibilities of administrative supervision and agreement management,and the lack of supervision ability and professional human resources.In this regard,we should speed up the legal construction and further improve the medical insurance fund supervision,distinguish the rights and responsibilities of administrative supervision and agreement management,and train professional supervision personnel to improve the supervision ability.