绍兴构建医保基金信用监管体系的实践探索

Practice and Exploration of Constructing the Credit Supervision System of Medical Insurance Fund in Shaoxing

2019年,绍兴市成功申报成为国家医保基金监管信用体系试点城市。一年多来,信用试点工作以习近平新时代中国特色社会主义思想为指导,在国家、省医保局的支持下,以定点零售药店为突破口,建立“1+3+1”医保基金监管信用体系,具体为开发一套评价体系、创建三大监管模式、联通一个应用平台,实现医保基金监管政府数字化转型的“信用引领、云上智治”,为全面筑牢医保基金监管防线,确保医保基金安全运行提供保障。

In 2019,Shaoxing became a pilot city for the construction of national medical insurance fund supervision credit system.Over the past year,with the support of the National and Zhejiang Healthcare Security Administration,Shaoxing has established a"1+3+1"medical insurance fund supervision credit system with designated retail pharmacies as the breakthrough point.The specifi c content of the pilot is to develop a set of evaluation system,create three supervision modes,and connect an application platform,so as to realize the digital transformation of the government of medical insurance fund supervision,so as to build a strong defense line of medical insurance fund supervision and ensure the safe operation of medical insurance fund.