The social insurance of Shenzhen office denies " Fish and enforce the law "

The social insurance of Shenzhen office denies " Fish and enforce the law "
The social insurance of Shenzhen office denies " Fish and enforce the law "
The intersection of staff reporter and Liu Fang Shenzhen have 656 fixed community health service centres at present ' Hereafter referred to as the health centre of the society) ,The society health centre served as the public health, these fixed convenient and nearby citizens of medical organization brush the medical insurance card and seek medical advice nearby. However, can't paste up the medical insurance card in some society health centres recently, the reason is hereafter referred to as the social insurance office by the social insured fund administration bureau of Shenzhen Punishment of delaying paying by credit card. The reporter will go and investigate, query to be " fished to enforce the law " by the social insurance office one after another in society health centres that is delayed paying by credit card ,And the social insurance office responds and says to this, this measure is to " agree to carry on management according to the contract " today ,Absolutely not administrative law enforcement. The social insurance office is pointed " Fish and enforce the law " Recently, the social insurance of Shenzhen office suspended the fixed qualifications of social insurance of 7 fixed medical organizations, among them 3 are suspended the qualification for 12 months, other 4 are suspended for 3 months. The investigation behavior of the social insurance office, is called " fishes to enforce the law " by the health centre of the society . According to relevant person in charge of social insurance office, since the 2009, the intersection of Shenzhen and the intersection of social insurance and according to controlling on the net office, find the phenomenon that the expenses of account keeping of the medical insurance unusually increase appears in some fixed medical organizations, then take the corresponding measure and investigate to the relevant fixed medical organization, take and observe publicly and investigate privately, transfer the prescription and treats singly and keep accounts to check with the computer more than the right, data materials way of checking the medicines stock movement in and out of the warhouse list etc. live. Verify through investigating, the social insurance office finds some fixed medical organizations have prescription treatment that keep accounts and does not accord with with the computer only, phenomena in breach of violation such as administration of ultra quantity, ultra limit administration and violating the price regulation to charge,etc., also not nuclear card, ledger clerk's not nuclear card,etc. exist and see the doctor to manage the problem of the aspect. Oing to work, in one afternoon in June of this year, a king of the health centre of society of lotus flower the north two of Feitian district of Shenzhen is surnamed that the doctor is going to work, according to the media, two middle aged women see the doctor, a person among them takes out a medical insurance card, doctor Wang find age of photos and sample and person who holds card I am very similar behind nuclear cards, write a prescription for the patient, but after the other side get medicines and note, two people are called in the social insurance office and checked. And the health centre of another society reflects, it has similarity that course and the former of the thing happen on the same day. A patient calls out back pain of waist after entering the door, sees a patient is very worried, this doctor on duty has not found time to pay making a diagnosis to the patient with nuclear card yet, while writing a prescription after making a diagnosis, find the intersection of social insurance and card and the intersection of I and picture, doctor query, but patients are called one's own one firmly, and urge the doctor to seem very angry constantly, the doctor have to write a prescription with the medical insurance card that the patient held. But after not writing a prescription, patient bright bright identity, it's proved staff member coming to check, office of social insurance. The social insurance of Shenzhen office indicates in the notice announcement that is issued on August 18: "Suspend the healthy and blissful clinic, general and help the clinic, qualification of fixed account keeping of medical organization of medical insurance of the clinic with one mind for 12 months, suspend and loose the health service centre of spring community big, long apricot clinic, health service centre of second community of the north of lotus flower, 3 months with the qualification of fixed account keeping of medical organization of medical insurance of the good traditional chinese medical science clinic. " Meanwhile, fined in some society health centres, its doctor on duty is dismissed too. " my feeling has been made fun of " Verifying the procedure of the medical insurance card according to the round regulation of the social insurance, the doctor only contrasts through ginseng sponsor's photo and holder at that time on the medical insurance card, it can be regarded as the nuclear cartoon that the appearance is basically unanimous. And not stipulated the medical insurance card should be shown and used with the ID card together. " after their on bright identity, my feeling has been made fun of " ,Centre director Liu GuiQin of society's health of lotus flower the north two says. Have one's mind filled with she who is hurt and wronged to think, this kind of behavior is had set and bored in by the doctor, can't make nuclearly the fact of the card on purpose, " to supervise the way of law enforcement being be like this? " "In fact, if supervisor goes to the health centre of the society to check the social insurance round normally, if find violation, there are no words naturally and can be spoken in the health centre of the society. " The person in charge of the health centre of a society says so. Complain except the intersection of society and the intersection of health and centre, have report think social insurance office park, paste up the intersection of medical insurance and punishment of Carlos to medical organization these too, cause the nearby patient to be difficult to seek medical advice finally. The 72 -year-old old man of north community of lotus flower Wang Yu only complains, he has to seek something far and wide when it is within reach in these days, go to the medical organization not known well oneself to see the doctor. For this reason, the old man of Wang YuGuang has also written one reflects the letter gives the society the health centre, hope to appeal for the social insurance office, let the health centre of these societies resume the qualification of paying by credit card. " fish and enforce the law " The contract supervises" this is not administrative law enforcement, but manage according to the contract "! " Will it be afternoon November 16, Shenzhen the intersection of social insurance and the intersection of office and the intersection of policies and regulations and yellow perilous peak, division chief of, so emphasize in the face of reporter repeatedly question. This is that a situation of social insurance of Shenzhen is right " Fish and enforce the law " Responding in the official side for the first time after the dispute. Yellow perilous peak say at first, social insurance organization and relation of hospital the third party's relation of supervision and management. The treatment to fixed medical organization of social insurance organization, it is according to the agreements of both sides, behavior of handling, correcting that to the fixed medical organization to agree on the noncompliance offering medical care not according to the agreement, a contract behavior is not the behavior of enforcing the law. Investigate and verify by the reporter, the 43rd regulation of chapter five of " fixed medical care agreement of medical organization of the social insurance of Shenzhen ", "Party A( Refer to the social insurance office) The method that can take many ways to combine together pays checking to the medical care that Party B offers in order to join sponsors, and exploit the abnormal condition offered by computer information system and carry on pointed special examination, raise the efficiency of management. " The ones that stipulated in the agreement checked the way to include investigating secretly. Article 16 has stipulated too Party A can adopt and observe publicly and investigate privately in " the social medical insurance of Shenzhen retailed the pharmacy and served the agreement by fixed position ", inspection way carries out the situation of the medical insurance policy to supervise and inspect Party B on the spot. Secondly, " there are 895 fixed medical organizations at present in Shenzhen, retail 617 pharmacies by fixed position, among them in the fixed society health centre ' Includes the clinic) 656 families, the distribution is in extensive range. If not through this way, it is very difficult to manage loophole of the medical organization, we have only more than 40 staff members, if every family is all in charge of, can not be in charge of over at all " . Yellow perilous peak say. Finally, the inconvenient query of seeing the doctor in the face of ordinary people, he says, after suspended the qualification of account keeping of the medical insurance in the specific fixed society health centre, join sponsor, can get the intersection of nearby and far away fixed medical organization go to a doctor, will seek medical advice, lead to the fact too big influence joining sponsoring. "Stop losing the medical organization in violation of rules and regulations, joining sponsors just takes several more steps, but it is that a money bag which joins the sponsor is damaged not to stop. " He explains. News from Shenzhen on November 16


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