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天津市医疗机构医疗保障定点管理办法政策解读
发布时间: 2021-07-14

yi、keyishenqingyingyatiyuyibaodingdiandeyiliaojigouyounaxie?

da: yingyatiyuyifadengjizhuce,qudeyiliaojigouzhiyexukezhenghuozhongyizhensuobeianzhengdeyiliaojigou,yijijingjunduizhuguanbumenpizhunjuyouweiminfuwuzizhidejunduiyiliaojigoukeshenqingyibaodingdian,jutibaokuo:

(yi)zongheyiyuan、zhongyiyiyuan、zhongxiyijieheyiyuan、minzuyiyiyuan、zhuankeyiyuan、kangfuyiyuan;

(er)zhuankejibingfangzhiyuan(suo、zhan)、fuyoubaojianyuan;

(san)shequweishengfuwuzhongxin(zhan)、zhongxinweishengyuan、xiangzhenweishengyuan、jiedaoweishengyuan、menzhenbu、zhensuo、weishengsuo(zhan)、yiwushi、cunweishengshi(suo);

(si)dulishezhidejijiuzhongxin;

(wu)anningliaohuzhongxin、xueyetouxizhongxin、huliyuan;

(liu)yanglaojigouneishedeyiliaojigou。

hulianwangyiyuankeyituoqishitiyiliaojigoushenqingqiandingbuchongxieyi,qitigongdeyiliaofuwusuochanshengdefuheyibaozhifufanweidexiangguanfeiyong,youjingbanjigouanguidingyuqisuoyituodeshitiyiliaojigoujinxingjiesuan。

er、yiliaojigoushenqingyibaodingdianyingjubeinaxiejibentiaojian?

da: shenqingyibaodingdiandeyiliaojigouyingjubeiyixiajibentiaojian:

(yi)zhengshiyunyingzhishao3geyue;

(er)zhishaoyou1mingqudeyishizhiyezhengshu、xiangcunyishengzhiyezhengshuhuozhongyi(zhuanzhang)yishizigezhengshuqiediyizhucedizaigaiyiliaojigoudeyishi;

(san)zhuyaofuzerenfuzeyibaogongzuo,peibeizhuan(jian)zhiyibaoguanlirenyuan;100zhangchuangweiyishangdeyiliaojigouyingsheneibuyibaoguanlibumen,anpaizhuanzhigongzuorenyuan;

(si)juyoufuheyibaoxieyiguanliyaoqiudeyibaoguanlizhidu、caiwuzhidu、tongjixinxiguanlizhidu、yiliaozhilianganquanhexinzhidudeng;

(wu)juyoufuheyibaoxieyiguanliyaoqiudeyiyuanxinxixitongjishuhejiekoubiaozhun,shixianyuyibaoxinxixitongyouxiaoduijie,anyaoqiuxiangyibaoxinxixitongchuansongjiuzhenrenyuanxiangguanxinxi,weicanbaorenyuan(hanyidijiuyicanbaorenyuan)tigongzhijielianwangjiesuan。sheliyibaoyaopin、zhenliaoxiangmu、yiliaofuwusheshi、yiyonghaocai、jibingbingzhongdengjichushujuku,anguidingshiyongguojiatongyideyibaobianma;

(liu)nenggoujierushiyiyaocaigouzhongxinyiyaocaigouyingyongpingtaidexinxixitong;

(qi)nenggouanguidinganzhuangshipinjiankong、shengwushibie、yaopinzhuisuxitongdengjianguansheshishebei;

(ba)cunweishengshi(suo)yingfuheyingyatiyucunweishengshibiaozhunhuajianshetiaojian,qieyuweishengyuan(xiangzhenyiyuan,shequweishengfuwuzhongxin)shixing“wutongyi”guanli(tongyirenyuanguanli、tongyiyewuguanli、tongyicaiwushouzhiguanli、tongyiyaopinjiyiliaoqixiegouxiaoguanli,tongyijixiaokaohehexinchoufenpeiguanli);

(jiu)anguidingyingdangjubeideqitatiaojian。

san、yiliaojigoutichuyibaodingdianshenqing,yingdangtigongnaxiecailiao?

da: yiliaojigouxiangyibaofenzhongxintichuyibaodingdianshenqing,yingdangtigongyixiacailiao:

(yi)dingdianyiliaojigoushenqingbiao;

(er)yiliaojigouzhiyexukezhenghuozhongyizhensuobeianzhenghuojunduiyiliaojigouweiminfuwuxukezhengzhaofuyinjian;

(san)yingyezhizhao(huoshiyedanweifarenzhengshu、minbanfeiqiyedanweidengjizhengshu)fuyinjian,jiefangjun、wuzhuangjingchabuduisuoshuyiliaojigouxutigong《zhongguorenminjiefangjunshiyedanweiyouchangfuwuxukezheng》huozhongguorenminjiefangjunchujudexiangguanpizhunziliaodengzhutizizhifuyinjian;

(si)fadingdaibiaoren、zhuyaofuzerenhuoshijikongzhirenshenfenzhengfuyinjian;

(wu)yuyibaozhengceduiyingdeneibuguanlizhiduhecaiwuzhiduwenben;

(liu)yuyibaoyouguandeyiliaojigouxinxixitongxiangguancailiao;

(qi)narudingdianhoushiyongyiliaobaozhangjijindeyucexingfenxibaogao;

(ba)anxiangguanguidingxutigongdeqitacailiao。

si、yiliaojigoushenqingyibaodingdianbanlichengxushishenme?

da: (yi)yiliaojigouxiangyibaofenzhongxintichudingdianshenqing,yibaofenzhongxinyingjishishouli。duishenqingcailiaoneirongbuquande,yibaofenzhongxinzishoudaocailiaozhiriqi5gegongzuorineiyicixinggaozhiyiliaojigoubuchong。

(er)yibaofenzhongxinyingzuzhipingguxiaozuhuoweituodisanfangjigou,yishumian、xianchangdengxingshikaizhanpinggu。pingguxiaozuchengyuanyouyiliaobaozhang、yiyaoweisheng、caiwuguanli、xinxijishudengzhuanyerenyuangoucheng。zishoulishenqingcailiaozhiriqi,pinggushijianbuchaoguo3geyue,yiliaojigoubuchongcailiaoshijianbujirupingguqixian。pingguneirongbaokuo:

1.hechayiliaojigouzhiyexukezhenghuozhongyizhensuobeianzhenghuojunduiyiliaojigouweiminfuwuxukezheng;

2.hechayishi、hushi、yaoxuejiyijidengzhuanyejishurenyuanzhiyexinxiheyishidiyizhucedixinxi;

3.hechayufuwugongnengxiangshiyingdezhenduan、zhiliao、shoushu、zhuyuan、yaopinzhucunjifafang、jianchajianyanfangshedengjichusheshiheyiqishebei;

4.hechayuyibaozhengceduiyingdeneibuguanlizhiduhecaiwuzhidu,weishengjiankangbumenyiliaojigoupingshendejieguo;

5.hechayuyibaoyouguandeyiliaojigouxinxixitongshifoujubeikaizhanzhijielianwangjiesuandetiaojian。

6.hechayiliaojigoushifoucunzaibenbanfadishiertiaoguidingdebuyushouliqingxing;

7.hechayiliaojigoudexinyongbaogao;

8.hechayiliaojigouanxiangguanguidingyingtigongdeqitacailiao。

pinggujieguofenweihegehebuhege。yibaofenzhongxinyingjiangpinggujieguobaoquyiliaobaozhangjubeian。duiyupingguhegede,naruniqiandingxieyiyiliaojigoumingdan,bingxiangshehuigongshi。duiyupinggubuhegede,yinggaozhiqiliyou,tichuzhenggaijianyi。zijieguogaozhisongdazhiriqi,zhenggai3geyuehoukezaicizuzhipinggu,pinggurengbuhegede,1nianneibudezaicishenqing。

(san)pingguhegeyiliaojigou,anyaoqiuwanchengyiyaocaigouyingyongpingtaixinxixitong、jiandujianchasheshishebeideanzhuangdiaoshihou,yibaofenzhongxinyuyiliaojigouxieshangtanpan,dachengyizhide,shuangfangziyuanqiandingyibaoxieyi。yibaofenzhongxinyinganyuejiangqiandingxieyimingdanxiangquyiliaobaozhangjuheshiyibaozhongxinbeian,shiyibaozhongxinanyuehuizonggequqiandingxieyimingdanxiangshiyiliaobaozhangjubeian。yibaoxieyiyingmingqueshuangfangquanli、yiwuhezeren。qiandingyibaoxieyideshuangfangyingdangyangezhixingxieyiyueding。xieyiqixianyibanwei1nian。

(si)shiyibaozhongxinyingxiangshehuigongbuqiandingyibaoxieyidedingdianyiliaojigouxinxi,baokuomingcheng、dizhideng,gongcanbaorenyuanxuanze。

wu、yiliaojigouyounaxieqingxing,buyushouliyibaodingdianshenqing?

da: yiliaojigouyouxialieqingxingzhiyide,buyushoulidingdianshenqing:

(yi)yiyiliaomeirong、fuzhushengzhi、shenghuozhaohu、zhongzhiyadengfeijibenyiliaofuwuweizhuyaozhiyefanweide;

(er)jibenyiliaofuwuweizhixingyiliaobaozhangxingzhengbumenzhidingdeyiyaojiagezhengcede;

(san)weiyifalvxingxingzhengchufazerende;

(si)yinongxuzuojiadengbuzhengdangshouduanshenqingdingdian,zifaxianzhiriqiweiman3niande;

(wu)yinweifaweiguibeijiechuyibaoxieyiweiman3nianhuoyiman3niandanweiwanquanlvxingxingzhengchufafalvzerende;

(liu)yinyanzhongweifanyibaoxieyiyuedingerbeijiechuxieyiweiman1nianhuoyiman1niandanweiwanquanlvxingweiyuezerende;

(qi)fadingdaibiaoren、zhuyaofuzerenhuoshijikongzhirencengyinyanzhongweifaweiguidaozhiyuandingdianyiliaojigoubeijiechuyibaoxieyi,weiman5niande;

(ba)fadingdaibiaoren、zhuyaofuzerenhuoshijikongzhirenbeilierushixinrenmingdande;

(jiu)falvfaguiguidingdeqitabuyushoulideqingxing。

liu、dingdianyiliaojigouweicanbaorenyuantigongzhenliaofuwuyounaxieyaoqiu?

da: dingdianyiliaojigoujiqigongzuorenyuanyingdangzhixingshimingjiuyihegouyaoguanliguiding,heyancanbaorenyuanyouxiaoshenfenpingzheng,anzhaozhenliaoguifantigongheli、biyaodeyiyaofuwu,xiangcanbaorenyuanrushichujufeiyongdanjuhexiangguanziliao,budefenjiezhuyuan、guachuangzhuyuan,budeweifanzhenliaoguifanguoduzhenliao、guodujiancha、fenjiechufang、chaoliangkaiyao、zhongfukaiyao,budezhongfushoufei、chaobiaozhunshoufei、fenjiexiangmushoufei,budechuanhuanyaopin、yiyonghaocai、zhenliaoxiangmuhefuwusheshi,budeyoudao、xiezhutarenmaominghuozhexujiajiuyi、gouyao。budebayibaozhifufanweineidefeiyongheyibaojufudefeiyongzhuanyoucanbaorenyuanchengdan。

qi、dingdianyiliaojigouduinarucaigoufanweideyaopinheyiyonghaocaishifoutongguotianjinshiyiyaocaigouyingyongpingtaishangcaigou?

da: dingdianyiliaojigouyinganyouguanguiding,duinarucaigoufanweideyaopinheyiyonghaocaizaitianjinshiyiyaocaigouyingyongpingtaishangcaigou,zuodaoyingcaijincai。youxianshiyongjizhongcaigouzhongxuandeyaopinheyiyonghaocai。zhenshijiluyaopinheyiyonghaocai“jin、xiao、cun”dengqingkuang。

ba、jingbanjigoufaxiandingdianyiliaojigoucunzaiweifanyibaoxieyiyuedingqingxingde,keannaxiefangshijinxingchuli?

da: jingbanjigoufaxiandingdianyiliaojigoucunzaiweifanyibaoxieyiyuedingqingxingde,keanxieyiyuedingdanduhuolianhecaiquyixiachulifangshi:

(yi)yuetanyiliaojigoufadingdaibiaoren、zhuyaofuzerenhuoshijikongzhiren;

(er)zantinghuobuyubofufeiyong;

(san)buyuzhifuhuozhuihuiyizhifudeyibaofeiyong;

(si)yaoqiudingdianyiliaojigouanzhaoxieyiyuedingzhifuweiyuejin;

(wu)zhongzhixiangguanzerenrenyuanhuozhesuozaibumenshejiyiliaobaozhangjijinshiyongdeyiliaofuwu;

(liu)zhongzhihuojiechuyibaoxieyi。

jiu、dingdianyiliaojigounaxiexinxifashengbiangengshi,yingtichubiangengshenqing?

da: dingdianyiliaojigoudemingcheng、fadingdaibiaoren、zhuyaofuzerenhuoshijikongzhiren、zhucedizhi、yinxingzhanghu、zhenliaokemu、jigouguimo、jigouxingzhi、dengjiheleibiedengzhongdaxinxibiangengshi,yingziyouguanbumenpizhunzhiriqi30gegongzuorineixiangyibaofenzhongxintichubiangengshenqing。qitayibanxinxibiangengyingjishishumiangaozhi。

shi、dingdianyiliaojigouyounaxieqingxing,jingbanjigouyingzhongzhiyibaoxieyi?

da: dingdianyiliaojigouyouxialieqingxingzhiyide,jingbanjigouyingzhongzhiyibaoxieyi:

(yi)genjurichangjianchahejixiaokaohe,faxianduiyiliaobaozhangjijinanquanhecanbaorenyuanquanyikenengzaochengzhongdafengxiande;

(er)weianguidingxiangyiliaobaozhangxingzhengbumenjijingbanjigoutigongyouguanshuju、shipinjiankongyingxiangziliaohuotigongshuju、shipinjiankongyingxiangziliaobuzhenshide;

(san)genjuyibaoxieyiyuedingyingdangzhongzhiyibaoxieyide;

(si)falvfaguiheguizhangguidingdeyingdangzhongzhideqitaqingxing。

shiyi、dingdianyiliaojigouyounaxieqingxing,jingbanjigouyingjiechuyibaoxieyi?

da: yibaoxieyijiechushizhijingbanjigouyudingdianyiliaojigouzhijiandeyibaoxieyijiechu,xieyiguanxibuzaicunxu,xieyijiechuhouchanshengdeyiyaofeiyong,yiliaobaozhangjijinbuzaijiesuan。dingdianyiliaojigouyouyixiaqingxingzhiyide,jingbanjigouyingjiechuyibaoxieyi,bingxiangshehuigongbujiechuyibaoxieyideyiliaojigoumingdan:

(yi)yibaoxieyiyouxiaoqineileiji2cijiyishangbeizhongzhiyibaoxieyihuozhongzhiyibaoxieyiqijianweianyaoqiuzhenggaihuozhenggaibudaoweide;

(er)yinongxuzuojiadengbuzhengdangshouduanshenqingqudedingdiande;

(san)jingyiliaobaozhangbumenheqitayouguanbumenchashiyouqizhapianbaoxingwei,qingjieyanzhongde;

(si)weifeidingdianyiliaojigouhuochuyuzhongzhiyibaoxieyiqijiandeyiliaojigoutigongyibaofeiyongjiesuande;

(wu)jujue、zunaohuobupeiheyiliaobaozhangbumenkaizhanzhinengshenhe、jixiaokaohe、jiandujianchadeng,qingjieeliede;

(liu)beifaxianzhongdaxinxifashengbiangengdanweibanlizhongdaxinxibiangengde;

(qi)dingdianyiliaojigoutingyehuoxieyehouweianguidingxiangjingbanjigoubaogaode;

(ba)yiliaobaozhangxingzhengbumenhuoqitayouguanbumenzaixingzhengzhifazhong,faxiandingdianyiliaojigoucunzaizhongdaweifaweiguixingweiqiekenengzaochengyiliaobaozhangjijinzhongdasunshide;

(jiu)beidiaoxiao、zhuxiaoyiliaojigouzhiyexukezhenghuozhongyizhensuobeianzhengde;

(shi)fadingdaibiaoren、zhuyaofuzerenhuoshijikongzhirenbunenglvxingyibaoxieyiyueding,huoyouweifashixinxingweide;

(shiyi)weiyifalvxingyiliaobaozhangxingzhengbumenzuochudexingzhengchufajuedingde;

(shier)dingdianyiliaojigouzhudongtichujiechuyibaoxieyiqiejingbanjigoutongyide;

(shisan)genjuyibaoxieyiyuedingyingdangjiechuyibaoxieyide;

(shisi)falvfaguiheguizhangguidingdeyingdangjiechudeqitaqingxing。

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