Hospital Hospital Medical Insurance Funds Supervision Targeted Governance
目的：探索建立医院医保基金监管长效机制。方法：通过开展医保基金监管专项治理行动，分析骗保发生原因，采取相应举措，逐步建立健全制度执行机制、宣传培训机制、负面清单机制等9大机制。结果：医保基金监管长效机制提高了医务人员法律意识，规范了医保服务行为和价格收费行为。结论：医院建立医保基金监管长效机制，并根据工作要求和情况的变化持续改进和完善，从业务发生源头提升基金风险防控能力，保障医院医保基金安全高效运行，为医院可持续发展提供动力。
Objective：Explore the establishment of a long-term mechanism for the supervision of hospital medical insurance funds. Method：Through carrying out special governance actions for the supervision of medical insurance funds，analyzing the causes of fraudulent insurance，and taking corresponding measures，gradually establish and improve 9 major mechanisms including system implementation，publicity and training，and negative list. Result：The long-term mechanism of medical insurance fund supervision has improved the legal awareness of medical staff，and regulated medical insurance service behavior and price charging behavior. Conclusion：The hospital established a long-term mechanism for the supervision of medical insurance funds，and continuously perfected it according to changes in work requirements and circumstances，improved fund risk prevention and control capabilities from the source of business，guaranteed the safe and efficient operation of hospital medical insurance funds，and provided power for the sustainable development of the hospital.