南京市医保智能监控系统建设的特点与成效分析

Analysis on the Characteristics and Effectiveness of the Construction of Healthcare Security Intelligent Monitoring System in Nanjing

医疗保障基金使用主体多、链条长、风险点多、监管难度大,监管形势一直比较严峻。南京市医疗保险管理中心(以下简称南京市医保中心)为建设高效能的医保智能监控系统,按照国家医保局和江苏省医保局的要求,依据《医疗保障基金使用监督管理条例》的规定,以务实创新的进取精神,持续推进医保智能监控系统建设,分三期建立了具有全面性、整体性、有效性、贯通性、精准性和周密性等6个特点的医保智能监控系统,成为织密织牢基金安全保障网的科技支撑,有效保障了医保基金安全。

Healthcare security fund has a long chain,many risk points and many users,and the regulatory situation has been severe.In order to build an efficient healthcare security intelligent monitoring system,Nanjing Medical Insurance Management Center continues to promote the construction of healthcare security intelligent monitoring system in accordance with the requirements of the National Healthcare Security Bureau and Jiangsu Healthcare Security Bureau and The Regulations on the Supervision and Administration of the Use of Healthcare Security Funds.Nanjing has established a healthcare security intelligent monitoring system with six characteristics of comprehensiveness,integrity,effectiveness,penetration,accuracy and thoroughness in three phases,effectively ensuring the safety of healthcare security funds.