chi-thi-10-ct-byt-2019-phong-chong-hanh-vi-lam-dung-truc-loi-quy-bao-hiem-y-te

BOYTE CONG HOA xA H()1 CHU NGHiA Vq:T NAM DQc l~p - TV - H~nh phuc S6: -10 ICT-BYT Ha N9i, 09 thang ndm 2019 CHiTHI V~ vi~c tang cuong cong tac phong, chang hanh vi lam dung, true lQi quy bao hi~m y t~ Trong nhtrng nam qua, thirc hien Luat bao hiem y tS, Luat kham benh, chua benh va cac quy dinh lien quan, cac co kham benh, chua benh tren ca mroc da tri@nkhai thuc hien d6ng bQ nhieu giai phap, nhu: d6i moi co chS quan ly, cai each thu tuc hanh chinh, phat tri@nkhoa hoc, ky thuat, cai tiSn chat hrong chuyen mon, nang cao ch~t hrong kham benh, chua benh, dap irng su hai long cua nguoi benh co the bao hiem y tS, dam bao quyen loi cua nguoi benh thea quy dinh cua phap luat, gop ph~n quan trngtrong th\l'c hi~n m\lC tieu bao hi@m y to~mdan Tuy nhien, thai gian g§n day, qua cong tac tra, ki@mtra da phat hi~n co tinh tr~ng l~m d\lng su d\lng dich V\l y tS, gian l~, tf\lC lqi quy bao hi@my tS, anh huang dSn vi~c su d\lng quy bao hi@my tS, dSn quySn lqi cua nguai b~nh, uy tin cua nganh y tS, Y nghia nhan van cua chinh sach bao hi@my tS Nguyen nhan xay tinh tr~ng tren chu ySu la mQt bQ ph~n nguai lao dQng nganh y tS thiSu kiSn thuc va hi@ubiSt chinh sach, phap lu~t vS bao hi@my tS, chua tuan thu dAy du cac quy dinh vS t6 chuc kham b~nh, chua b~nh; h~n chS vS kiSn thuc, nang l\l'c chuyen mon; S\l'ph6i hqp giua nganh Y tS va nganh Bao hi@mxa hQi cong tac chi d~o, ki@mtra, giam sat chua thuang xuyen, lien t\lC d@kip thai phat hi~n, ch~n chinh nhiing thiSu sot va giai quySt vuang m~c phat sinh D@kip thai ngan ch~n hanh vi l~m d\lng, gian l~n, tf\lC 19i quy bao hi@my tS~ dam bao quySn lqi cua nguai tham gia bao hi@my tS va su d\lng quy bao hi@my tS hqp ly, hi~u qua, BQ truang BQ Y tS yeu cAu: Giam d6c Sa Y tS cac tinh, ph6 tf\l'C thuQc Trung uang, Thu truang Y tS cac bQ, nganh: a) Tang cuang cong tac tham muu th\l'c hi~n nhi~m V\l quan ly nha nuac vS bao hi@my tS, cong tac tuyen truySn, giao d\lc ph6 biSn chinh sach, phap lu~t vS bao hi@my tS, vS kham b~nh, chua b~nh Chu y dSn cac nQi dung lien quan dSn kham b~nh, chua b~nh bao hi@my tS thea quy dinh cua Lu~t bao hiSm y tS, Lu~t kham b~nh, chua'b~nh, N~hi dinh s6 1~6/2018/ND-CP 17/10/2018 cua Chinh phu Quy dinh chi tiet va huang dan bi~n phap thi hanh mQt s6 diSu cua Lu~t bao hi@m y tS, Nghi dinh s6 176/20 13/ND-CP 1411112013 cua Chinh phu vS xu ph~t vi ph~m hanh chinh linh V\l'CY tS, Nghi quySt s6 OS/2019INQ-HDTP 18/8/2019 cua HQi d6ng ThAm phan sa is Toa an Nhan dan TBi cao vS Huang dan ap dung DiSu 214 vS T9i gian l~n bao hiem xa hoi, bao hiem thAt nghiep, DiSu 215 vS T9i gian l~n bao hiem y tS va DiSu 216 vS T9i tron dong bao hiem xa h9i, bao hiSm y tS, bao hiem thAt nghiep cho nguoi lao dong cua B9 Luat hinh sir va cac quy dinh khac cua phap luat b) Chi dao cac co sa kham benh, chua benh tang cirong cong tac tv kiem tra phong chong hanh vi lam dung, gian 1~, true loi quy bao hiem y tS tai cac co sa kham benh, chua benh, nhat Ia sau Chinh phu ban hanh Nghi dinh sB 146/20181NE>-CP, B9 tnrong B9 Y tS ban hanh cac Thong tu diSu chinh gia dich vu y tS c) PhBi hQ'Pvoi Bao hiem xa h9i tinh, phB chi d';lot6 chuc tra, kiSm tra cong tac kham b~nh, chua b~nh bao hiSm y tS; dAu th~u, cung ilng, quan ly va su d\lng thuBc, hoa chAt, v~t tu y tS va toan chi phi kham b~nh, chua b~nh bao hiSm y tS t';li cac cO'sa kham b~nh, chua b~nh thu9C quySn quan ly; phong ngira va kip thai phat hi~n cac hanh vi l';lm d\lng, gian l~n, tr\lc IQ'iquy bao hiSm y tS, bao cao cAp co thfim quySn dS xu ly nghiem cac hanh vi vi ph';lm vS bao hiSm y tS 2; Giam dBc b~nh vi~n, vi~n co giuOng b~nh, cO'sa kham b~nh, chua b~nh cac tuyen: · a) Co kS hO';lchkiSm tra, giam sat, chAn chinh cong tac kham b~nh, chua b~nh bao hiSm y tS, d~c bi~t chu trY t~ (d~ th\lc hi~n); - C6ng TTDT Chinh phil; - C6ng TTDT Be>Y t~; - Luu: VT, BH Nguy~n Thi Kim Ti~n