隆阳区医保部门2019年度工作总结
- 索引号
- 23828288112-1-30/2019-1127001
- 发文机构
- 隆阳区医疗保障局
- 公开目录
- 工作动态
- 文 号
- 浏览量
- 日期
- 2019-11-12
<style>
@font-face{
font-family:"Times New Roman";}
@font-face{
font-family:"宋体";}
@font-face{
font-family:"Calibri";}
@font-face{
font-family:"Wingdings";}
@font-face{
font-family:"黑体";}
@font-face{
font-family:"方正小标宋_GBK";}
@font-face{
font-family:"方正仿宋_GBK";}
@font-face{
font-family:"方正黑体_GBK";}
@font-face{
font-family:"方正楷体_GBK";}
@font-face{
font-family:"仿宋_GB2312";}
@list l0:level1{
mso-level-number-format:chinese-counting;
mso-level-suffix:none;
mso-level-text:"（%1）";
mso-level-tab-stop:none;
mso-level-number-position:left;
margin-left:0.0000pt;
text-indent:0.0000pt;
font-family:宋体;}
p.MsoNormal{
mso-style-name:正文;
mso-style-parent:"";
mso-style-next:"table of figures";
margin:0pt;
margin-bottom:.0001pt;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
span.10{
font-family:Calibri;}
p.p{
mso-style-name:"普通\(网站\)";
margin-top:5.0000pt;
margin-bottom:5.0000pt;
mso-margin-top-alt:auto;
mso-margin-bottom-alt:auto;
mso-pagination:none;
text-align:left;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:12.0000pt;}
p.MsoHeader{
mso-style-name:页眉;
margin:0pt;
margin-bottom:.0001pt;
border-top:none;
mso-border-top-alt:none;
border-right:none;
mso-border-right-alt:none;
border-bottom:none;
mso-border-bottom-alt:none;
border-left:none;
mso-border-left-alt:none;
padding:1pt 4pt 1pt 4pt ;
layout-grid-mode:char;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:9.0000pt;
mso-font-kerning:1.0000pt;}
p.MsoFooter{
mso-style-name:页脚;
margin:0pt;
margin-bottom:.0001pt;
layout-grid-mode:char;
mso-pagination:none;
text-align:left;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:9.0000pt;
mso-font-kerning:1.0000pt;}
p.18{
mso-style-name:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
mso-style-next:"table of figures";
margin:0pt;
margin-bottom:.0001pt;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:'Times New Roman';
mso-fareast-font-family:宋体;
mso-bidi-font-family:黑体;
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
p.19{
mso-style-name:"table of figures";
mso-style-parent:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
mso-style-next:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
margin-left:10.0000pt;
mso-para-margin-left:2.0000gd;
text-indent:-10.0000pt;
mso-char-indent-count:-2.0000;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:'Times New Roman';
mso-fareast-font-family:宋体;
mso-bidi-font-family:黑体;
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
span.msoIns{
mso-style-type:export-only;
mso-style-name:"";
text-decoration:underline;
text-underline:single;
color:blue;}
span.msoDel{
mso-style-type:export-only;
mso-style-name:"";
text-decoration:line-through;
color:red;}
table.MsoNormalTable{
mso-style-name:普通表格;
mso-style-parent:"";
mso-style-noshow:yes;
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-padding-alt:0.0000pt 5.4000pt 0.0000pt 5.4000pt;
mso-para-margin:0pt;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-family:'Times New Roman';
font-size:10.0000pt;
mso-ansi-language:#0400;
mso-fareast-language:#0400;
mso-bidi-language:#0400;}
@page{mso-page-border-surround-header:no;
mso-page-border-surround-footer:no;}@page Section0{
margin-top:72.0000pt;
margin-bottom:72.0000pt;
margin-left:90.0000pt;
margin-right:90.0000pt;
size:595.3000pt 841.9000pt;
layout-grid:15.6000pt;}
div.Section0{page:Section0;}</style>
<!--StartFragment-->
<div class="Section0" style="layout-grid: 15.6pt none">
<p class="MsoNormal" align="center" style="text-align: center"><span style="font-family: 方正小标宋_GBK; font-size: 22pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正小标宋_GBK">隆阳区医保部门</font>2019年度工作总结</span><span style="font-family: 方正小标宋_GBK; font-size: 22pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<!--?xml:namespace prefix="o" /-->
<!--?xml:namespace prefix="o" /-->
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="text-align: left; line-height: 27pt; text-indent: 32pt; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">在</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">区委区政府</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">的正确领导下，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">在市医疗保障局的指导帮助下，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">按照</font>“保基本、可持续、惠民生、推改革”的总体要求，把握形势、厘清思路、强化履职，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">推进隆阳医疗保障事业高质量跨越发展，现将一年来的工作汇报如下：</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">一、</font>2019年度工作取得的成绩</span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly; mso-list: l0 level1 lfo1"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><span style="mso-list: Ignore">（一）</span></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">参保征缴及基金收支情况</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span></b><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">参保目标完成情况</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年隆阳区医疗保险参保人数达</font><font face="宋体">88.49</font><font face="方正仿宋_GBK">万人，其中：职工医疗保险参保人数为</font><font face="宋体">3.94</font><font face="方正仿宋_GBK">万人，城乡居民医疗保险参保人数</font><font face="宋体">84.55</font><font face="方正仿宋_GBK">万人。参保人员中，</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年度全区建档立卡贫困人口共</font><font face="宋体">93980</font><font face="方正仿宋_GBK">人，已实现</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参加基本医疗保险及大病补充医疗保险。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.<font face="方正仿宋_GBK">医保基金收支情况</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>1<font face="方正仿宋_GBK">）城乡居民医保基金收支情况。</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年城乡居民</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">按参保人数应筹集资金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">62565.52</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：个人参保缴费标准</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">220</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>/<font face="方正仿宋_GBK">人</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，合计</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">845480</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人</font>×</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">220</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>=</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">18600.56</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元；各级财政补助</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">520</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>/<font face="方正仿宋_GBK">人</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，合计</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">845480</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人</font>×</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">520</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>=</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">43964.96</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。截至</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">10</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">月</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">24</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">日实际筹集资金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">61196.38</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，资金到位率为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">97.81%<font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">其</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">中：个人参保缴费实际收缴</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">17838.85</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元（与应筹集资金存在差异是因为财政代缴部份尚未到位）</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">；</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">各级财政补助到位</font>43357.53<font face="方正仿宋_GBK">万元</font><font face="宋体">(</font><font face="方正仿宋_GBK">中央财政补助资金</font><font face="宋体">34564.44</font><font face="方正仿宋_GBK">万元，省级财政补助到位</font><font face="宋体">7477.13</font><font face="方正仿宋_GBK">万元，市级财政补助到位</font><font face="宋体">274.56</font><font face="方正仿宋_GBK">万元，区级财政补助</font><font face="宋体">1041.40</font><font face="方正仿宋_GBK">万元</font><font face="宋体">,</font><font face="方正仿宋_GBK">），实际人均财政补助到位</font><font face="宋体">512.82</font><font face="方正仿宋_GBK">元</font><font face="宋体">/</font><font face="方正仿宋_GBK">人（中央补助尚未到位</font><font face="宋体">607.53</font><font face="方正仿宋_GBK">万元），完成比例</font><font face="宋体">98.62%</font><font face="方正仿宋_GBK">，利息收入</font><font face="宋体">42.27</font><font face="方正仿宋_GBK">万元（因基金实行市级统筹，个人缴费资金及财政补助资金按规定按时上解市级，故利息收入较上年大幅减少）。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>2<font face="方正仿宋_GBK">）城镇职工医保基金收支情况。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">征收职工医疗保险金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">16940</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：基本医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">12020</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，大病补充医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">814</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，公务员医疗补助</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">4106</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。支付医疗基金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">13103</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：支付基本医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">8005</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元；支付公务员医疗补助基金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">5098</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。全区参加离休人员医疗统筹的单位有</font>49 <font face="方正仿宋_GBK">个，参保人数为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">52</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人，离休人员医疗保障基金收入</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">39</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，支出</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">153</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）异地就医结算情况。截至</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，异地就医零星报账结算审核人次</font><font face="宋体">6545</font><font face="方正仿宋_GBK">人次，统筹基金支付</font><font face="宋体">641.13</font><font face="方正仿宋_GBK">万元。其中：城镇职工住院手工结算</font><font face="宋体">156</font><font face="方正仿宋_GBK">人次，特慢病门诊</font><font face="宋体">185</font><font face="方正仿宋_GBK">人次，统筹基金支付</font><font face="宋体">245.43</font><font face="方正仿宋_GBK">万元，大病医保基金支付</font><font face="宋体">625.53</font><font face="方正仿宋_GBK">万元；城乡居民异地结算</font><font face="宋体">5725</font><font face="方正仿宋_GBK">人次，特慢病门诊</font><font face="宋体">479</font><font face="方正仿宋_GBK">人次。统筹基金支付</font><font face="宋体">3253.6</font><font face="方正仿宋_GBK">万元，大病保险支付</font><font face="宋体">1392.04</font><font face="方正仿宋_GBK">万元，医疗救助补助</font><font face="宋体">56.02</font><font face="方正仿宋_GBK">万元，兜底资金补助</font><font face="宋体">36.6</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>4<font face="方正仿宋_GBK">）定点医疗机构医疗保障基金清算情况。根据《保山市医疗保险服务中心关于对</font><font face="宋体">2018</font><font face="方正仿宋_GBK">年度城乡居民医疗保险超支分担及城镇职工医疗保险超支清算的通知》（保医保中心</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）文件要求，结合我区实际情况，我局制定了《</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2018<font face="方正仿宋_GBK">年度隆阳区医疗保障基金清算方案》，当年基金超支</font><font face="宋体">3%</font><font face="方正仿宋_GBK">以内的（按当年实际收入计算，全额</font><font face="宋体">3%</font><font face="方正仿宋_GBK">），由市级动用历年结余全额调剂，基金超支</font><font face="宋体">3%</font><font face="方正仿宋_GBK">—</font><font face="宋体">5%</font><font face="方正仿宋_GBK">（含</font><font face="宋体">5%</font><font face="方正仿宋_GBK">）的部分，由市级调剂补助</font><font face="宋体">50%</font><font face="方正仿宋_GBK">，县（市、区）承担</font><font face="宋体">50%</font><font face="方正仿宋_GBK">；基金超支</font><font face="宋体">5%</font><font face="方正仿宋_GBK">以上的部分由县（市、区）级承担。隆阳区</font><font face="宋体">2018</font><font face="方正仿宋_GBK">年基金收入</font><font face="宋体">56857.62</font><font face="方正仿宋_GBK">万元，全年超指标</font><font face="宋体">13180</font><font face="方正仿宋_GBK">万元，全年结算后剩余</font><font face="宋体">6154</font><font face="方正仿宋_GBK">万元，超支基金</font><font face="宋体">7024.57</font><font face="方正仿宋_GBK">万元，超支</font><font face="宋体">12%</font><font face="方正仿宋_GBK">，市级承担</font><font face="宋体">3%</font><font face="方正仿宋_GBK">承担金额</font><font face="宋体">1706</font><font face="方正仿宋_GBK">万元。完成隆阳区城乡居民医疗保险指标内清算合计</font><font face="宋体">1169.19</font><font face="方正仿宋_GBK">万元，超指标清算</font><font face="宋体">7266.74</font><font face="方正仿宋_GBK">万元；城镇职工医疗保险基金指标内清算合计</font><font face="宋体">594.5</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-indent: 29.6pt; mso-char-indent-count: 1.8500"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>5<font face="方正仿宋_GBK">）医疗救助工作开展情况。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">截止</font>10月20日，</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">个人缴费</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">直接</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">资助</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">建档立卡贫困户</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">93980</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">人，金额</font>912</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">6</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">4万</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；城镇低保户</font>6881户12097人，金额143</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">06</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；农村低保户</font>17744户21761人，金额261</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">13</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；特困户</font>2438户3413人，无主精神病人138人，金额78</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">12</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。住院</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">医疗</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">救助</font>9738人次，支付医疗救助资金1189</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">0</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">7</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。其中建档立卡贫困人口</font>6509人次，金额722</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">67元；城乡低保特困人口3229人次，金额466</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">4</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（二）</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正楷体_GBK">年重点工作完成情况</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">压实医保扶贫责任，助力全区脱贫攻坚工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">落实建档立卡人员医保倾斜待遇。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">严格按照《云南省健康扶贫</font>30<font face="方正仿宋_GBK">条措施》及有关政策要求，提高贫困人口基本医疗、大病保险报销比例</font><font face="宋体">10%</font><font face="方正仿宋_GBK">至</font><font face="宋体">20%</font><font face="方正仿宋_GBK">，降低大病报销起付线及提高大病保险报销上限各</font><font face="宋体">50%</font><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">开展贫困人员数据动态管理，将新识别的贫困人口已缴纳</font> <font face="方正仿宋_GBK">参保费用</font>220<font face="方正仿宋_GBK">元的，给予每人</font><font face="宋体">180</font><font face="方正仿宋_GBK">元的退款，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">合计退款</font>312<font face="方正仿宋_GBK">人次</font><font face="宋体">56160</font><font face="方正仿宋_GBK">元。对个人缴费</font><font face="宋体">40</font><font face="方正仿宋_GBK">元，财政代缴</font><font face="宋体">180</font><font face="方正仿宋_GBK">元被剔除贫困户的人员，补收财政代缴</font><font face="宋体">180</font><font face="方正仿宋_GBK">元，经动员不缴费参保的，退回个人缴费部分</font><font face="宋体">40</font><font face="方正仿宋_GBK">元，取消</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年度的参保，合计退款</font><font face="宋体">187</font><font face="方正仿宋_GBK">人</font><font face="宋体">7480</font><font face="方正仿宋_GBK">元。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">保障建档立卡贫困人口正常享受医疗保险待遇。截至</font>2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，全区建档立卡贫困人员住院</font><font face="宋体">16196</font><font face="方正仿宋_GBK">人次，总费用</font><font face="宋体">7817.18</font><font face="方正仿宋_GBK">万元，基本医疗报销</font><font face="宋体">5408.77</font><font face="方正仿宋_GBK">万元，大病保险报销</font><font face="宋体">440.15</font><font face="方正仿宋_GBK">万元，医疗救助</font><font face="宋体">811.72</font><font face="方正仿宋_GBK">万元，兜底保障</font><font face="宋体">267.5</font><font face="方正仿宋_GBK">万元，实际补偿比例达</font><font face="宋体">88.63%</font><font face="方正仿宋_GBK">，其中符合转诊转院规范的实际报销比为</font><font face="宋体">91.65%</font><font face="方正仿宋_GBK">，不符合转诊转院规范的实际报销比为</font><font face="宋体">45.6%</font><font face="方正仿宋_GBK">，有效防止了因病致贫返贫。门诊就诊</font><font face="宋体">229055</font><font face="方正仿宋_GBK">人次，医疗总费用</font><font face="宋体">807.1</font><font face="方正仿宋_GBK">万元，报销</font><font face="宋体">425.97</font><font face="方正仿宋_GBK">万元，报销比例</font><font face="宋体">52.78%</font><font face="方正仿宋_GBK">；特慢病门诊就诊</font><font face="宋体">7842</font><font face="方正仿宋_GBK">人次，总费用</font><font face="宋体">295.19</font><font face="方正仿宋_GBK">万元，报销</font><font face="宋体">236.03</font><font face="方正仿宋_GBK">万元，政策范围内报销比例</font><font face="宋体">82.04%</font><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">2.完成机构改革职能划转工作</span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成医保征管职责划转工作。如期完成城镇职工、城乡居民征管职能整体划转税务，确保了划转过渡期医疗保险征缴工作可持续、不间断，实现与税务部门数据实时交互，确保参保人员的政策待遇不受影响。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成医疗救助接续工作。根据机构改革职能划转及《保山市医疗保障局</font> <font face="方正仿宋_GBK">保山市民政局关于医疗救助交接有关事宜的通知》（医保电</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）等文件要求，医疗救助相关工作由区民政局按职能划转移交给区医疗保障局，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">6</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式移交。截至</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">31</font><font face="方正仿宋_GBK">日，医疗救助财政专户资金实际支付</font><font face="宋体">813.04</font><font face="方正仿宋_GBK">万元，结余</font><font face="宋体">470.41</font><font face="方正仿宋_GBK">万元；年初预算城乡医疗救助剩余指标金额</font><font face="宋体">370</font><font face="方正仿宋_GBK">万元，中央专项彩票公益金剩余指标金额</font><font face="宋体">103.8</font><font face="方正仿宋_GBK">万元。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成职工生育保险接续工作。职工生育保险相关工作由人社局按职能划转移交给区医疗保障局，</font>2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式移交。</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt"><font face="方正仿宋_GBK">完成定点医药机构服务协议签订工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">20</font><font face="方正仿宋_GBK">日至</font><font face="宋体">22</font><font face="方正仿宋_GBK">日，我局分别与</font><font face="宋体">49</font><font face="方正仿宋_GBK">家定点医疗机构进行了医疗服务协议谈判与签订工作。《</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年保山市医疗保险定点医疗机构服务协议》最大的亮点在于：甲方（医疗保障局）根据本统筹区医保基金收支预算情况，按照《保山市基本医疗保险总额控制管理暂行办法》对乙方（定点医疗机构）的年度医保付费实行总额控制。不仅提高基本医疗保险基金的使用效率，建立定点医疗机构主动控费机制，更有效控制了医疗费用不合理增长，确保基本医疗保险制度的可持续发展，是隆阳区结合实际，以医保基金收支预算管理为前提，以在线即时结算为基础，以保障参保人员基本医疗需求为目标，根据“以收定支、收支平衡、略有结余”的原则，实行“总额控制、按月结算、年终清算、结余留用、合理超支分担”的结算办法。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-fareast-font-family: 方正楷体_GBK; mso-bidi-font-family: 方正楷体_GBK">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">4.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt"><font face="方正仿宋_GBK">落实分级诊疗制度</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">根据《保山市医疗保障局关于完善城乡居民医疗保险转诊转院有关工作的通知》（保医保</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）文件精神，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">按照</font>2020<font face="方正仿宋_GBK">年争取形成“基层首诊、双向转诊、急慢分治、上下联动”为核心的较为完善的分级诊疗模式，基本实现“小病不出村、常见病不出乡、大病不出县、急危重症和疑难杂症不出市、康复在基层”的要求，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区于</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式实施分级诊疗制度。严格按照市级文件要求对未按转诊转院规范进行诊治的，其医疗费（含大病保险费用）在正常报销比例的基础上，分别下调了</font><font face="宋体">10</font><font face="方正仿宋_GBK">个百分点。</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">截至</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">2019</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">年</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">10</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">月全区</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">居民：</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">累计转诊患者</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">10082</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，其中由基层转诊到区级医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">47</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到区外市内医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">8957</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到省级或省外医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">966</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">，转到省内异地就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">159</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。由区级医院转诊到基层医院进行康复治疗</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">11</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人。</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">职工：</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">累计转诊患者</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">606</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到区外市内医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">23</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到省级或省外医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">515</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">，转到省内异地就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">68</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">5.<font face="方正仿宋_GBK">完成城镇职工门诊慢性病待遇支付扩大至零售药店试点工作</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">为方便门诊慢性病参保患者就医购药和费用结算，不断提高医疗保障管理服务水平，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">将城镇职工基本医疗保险门诊慢性病待遇支付扩大至零售药店。结合隆阳实际，坚持公开、公平、公正的原则及坚持总量控制、区域限制、比选择优的原则，通过</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">制定评审方案</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，对符合条件且愿承担门诊慢性病售药服务的定点药店组织专家评估和实地考察综合评估，并将结果公示</font>7</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">个工作日</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，最终在主城内确定</font>18<font face="方正仿宋_GBK">家定点药店为“城镇职工门诊慢性病待遇支付定点药店”</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">6.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">落实稽核职责，维护基金安全见实效</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。为强化基金监管，对定点医药机构全面稽核，开展定点医药机构专项治理工作，制定《隆阳区医疗保障局开展定点医药机构专项治理工作方案》《隆阳区</font>2019<font face="方正仿宋_GBK">年打击欺诈骗保专项行动月工作方案》，以开展专项治理为契机，逐一排查全区定点医药机构的违法违规行为，实现对定点医药机构的稽核稽查全覆盖。截止</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，通过人工、智能审核城镇职工医保查处定点医疗机构</font><font face="宋体">32</font><font face="方正仿宋_GBK">家，扣回医保基金</font><font face="宋体">8.7</font><font face="方正仿宋_GBK">万元，城乡居民医保查处定点医疗机构</font><font face="宋体">50</font><font face="方正仿宋_GBK">家，扣回医保基金</font><font face="宋体">18.96</font><font face="方正仿宋_GBK">万元。通过</font><font face="宋体">9</font><font face="方正仿宋_GBK">月份对医药机构专项治理，对辖区内</font><font face="宋体">50</font><font face="方正仿宋_GBK">家定点医药机构进行全面核查，</font></span><span style="font-family: 方正仿宋_GBK; letter-spacing: 0.7pt; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">共追回违规资金</font>(<font face="方正仿宋_GBK">含大病审核拒付</font><font face="宋体">)769.6</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; letter-spacing: 0.7pt; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 27pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; padding-top: 0pt; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">7</span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">.</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">推进作风建设，紧抓主题教育</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">成立主题教育领导小组及办公室，制定《</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">隆阳区</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">医疗保障局开展</font>“不忘初心、牢记使命”主题教育</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">工作</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">方案》，把学习教育、调查研究、检视问题、整改落实有机融合、贯穿始终。召开</font>“不忘初心、牢记使命”主题教育启动会议，明确守初心、担使命、找差距、抓落实的总要求。制定主题教育学习计划，采取自学和集中学习方式，读原著、学原文、悟原理。围绕党的政治建设、全面从严治党、理想信念、宗旨性质、担当作为、政治纪律和政治规矩、党性修养、廉洁自律等8个专题，扎实开展集中研讨。坚持问题导向，聚焦医疗保障，围绕“党的建设、医疗保障脱贫攻坚、医保基金管理使用、窗口作风建设、医疗保障政策以及医疗服务价格调整、医疗保障基金运行和打击医保基金欺诈骗保”等6个方面调研主题，着力解决医保工作中的瓶颈问题。制定对照党章党规查找差距的工作方案，在原原本本学习《中国共产党党内重要法规汇编》，《中国共产党章程》《准则》《条例》的基础上，组织局党组班子成员、普通党员，从思想、政治、作风、能力、廉政方面自觉对照习近平新时代中国特色社会主义思想，对照“十八个是否”，多种形式找差距、查短板。制定专项整治的工作方案，把“改”字贯穿始终，逐一对照可问题开展专项整治，坚持边学边整改、边调研边整改、边检视边整改，确保整改以取得实效。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（三）</font>2019年本部门工作亮点</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">医保付费实行总额控制</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于：甲方（医疗保障局）根据本统筹区医保基金收支预算情况，按照《保山市基本医疗保险总额控制管理暂行办法》对乙方（定点医疗机构）的年度医保付费实行总额控制。不仅提高基本医疗保险基金的使用效率，建立定点医疗机构主动控费机制，更有效控制了医疗费用不合理增长，确保基本医疗保险制度的可持续发展。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">实行分级诊疗制度</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于差异化支付政策，对未按转诊转院规范进行诊治的（特殊情况除外），其医药费（含大病保险费）在正常报销比例的基础上，分别下调</font>10<font face="方正仿宋_GBK">个百分点。形成基层首诊、双向转诊、急慢分治、上下联动的分级诊疗模式。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">门诊慢性病待遇支付扩大至定点药店</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">推进基本医疗保险支付方式</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">的</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">改革</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">坚持合理布点</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">方便购药、自由选择的原则</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，方</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">便门诊慢性病参保患者就医购药和费用结算</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">提高医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">保障</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">管理服务水平</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">二、存在问题及短板</font></span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-shading: rgb(255,255,255)"><font face="方正楷体_GBK">（一）医保基金监管存在的问题</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">稽核</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人员配备不足。</font>2019<font face="方正仿宋_GBK">年隆阳区医疗保险参保人数达</font><font face="宋体">88.49</font><font face="方正仿宋_GBK">万人，承担辖区内</font><font face="宋体">49</font><font face="方正仿宋_GBK">家定点医疗机构及</font><font face="宋体">239</font><font face="方正仿宋_GBK">家定点药店医保基金监管工作，监管工作任务较重。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">跨省异地住院稽查难度较大</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">建议进一步完善跨省异地直接结算平台，既方便参保群众，又有效防止参保人员在外地虚开住院发票骗取套取医保基金的行为发生</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">承担意外伤害核查工作，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">意外伤害住院产生欺诈骗保情况较多，建议与公安、卫健、市场监管等部门建立协同机制，定期交换参保患者交通事故处理情况。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">四是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">机构改革后又新增</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">划入</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">了职能职责，但相关部门未转隶人员到我局，所有划转工作职责需现有</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">人员承担</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">，一人多责。</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)">
<o:p></o:p></span></p>
<p class="p" align="justify" style="text-justify: inter-ideograph; text-align: justify; line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; background: rgb(255,255,255); mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-shading: rgb(255,255,255)"><font face="方正楷体_GBK">（二）信息化系统存在问题</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">数据共享存在时间差。税务部门与医保部门信息系统数据部能实时对接，导致医保征收进度受影响，基层征缴人员征收工作缓慢推进。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">在执行</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">档立卡等特殊待遇时，仅依靠其他部门提供数据后比对，部分信息无法比对的只能依靠人工核实进行标记导致政策执行存在滞后；参保人员的状态变化因数据不共享导致享受待遇过多或不足，基金追回或补差甚为困难。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三</font></span></b><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">异地结算联网直接结算存在因网络延迟数据异常导致无法正常结算的问题</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">三、</font>2020年工作计划</span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（一）继续做好医保扶贫工作。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">紧紧围绕</font>“两不愁、三保障”做好医疗保障工作。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完善建档立卡人口参保管理、动态管理，确保建档立卡贫困人口</font>100%<font face="方正仿宋_GBK">参保并享受基本医疗、大病保险，符合条件的享受医疗救助的倾斜政策。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（二）继续加强医保基金的管理工作。</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">.<font face="方正仿宋_GBK">配合税务部门做好</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2020</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">年参保征缴工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">城乡居民征缴工作移交税务部门代征，我局将全面配合税务部门启动</font>2020<font face="方正仿宋_GBK">年医保征缴工作，完成参保任务，加大政策宣传，扩大参保面，在确保建档立卡贫困户</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参保的同时，力争全区城乡居民</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参加城乡居民医疗保险及大病医疗保险，有效防止因病返贫、因病致贫。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="19" style="text-indent: 32pt; text-autospace: ideograph-numeric; margin-left: 0pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">签订服务协议，加强基金管理工作。</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">实行医保基金总额控制政策，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">根据</font>“以收定支、收支平衡、略有结余”的原则，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">与定点医药机构签订</font>2020<font face="方正仿宋_GBK">年医保服务协议，制定清算方案，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">定期进行基金运行情况分析</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">对</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">费用控制指标使用率较高，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">就诊人次异常增长的定点医疗机构，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">重点稽核，发现</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">套取医保基金的违规行为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，按照相关规定</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">严管重</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">处</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 'Times New Roman'; font-size: 10.5pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 宋体; mso-bidi-font-family: 黑体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（三）加大分级诊疗政策宣传力度。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">围绕</font>“小病不出村、常见病不出乡、大病不出县”的要求，加大分级诊疗宣传力度，扩宽宣传渠道。将我局制作的<font face="宋体">MP3</font><font face="方正仿宋_GBK">、动漫视频、宣传单、折页及海报发放到各乡镇（街道）、村（社区）要求循环播放，并在醒目处粘贴海报；并要求各定点医疗机构对住院患者进行宣传，将政策宣传单发放到各科室，明确各科室宣传责任人，由各科室对在院患者进行宣传解读，将各医疗机构宣传力度纳入医保日常考核指标中。充分发挥县、乡、村三级医疗资源，认真落实分级诊疗转诊转院制度，自下而上解决疑难杂症、自上而下开展康复治疗，逐步形成“基层首诊、上下结合”的医疗体系。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="19" style="line-height: 28pt; text-indent: 32pt; text-autospace: ideograph-numeric; margin-left: 0pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（四）</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"> </span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">完善</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">“两病”门诊用药保障</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">机制。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">完善</font>“两病”门诊用药保障机制，是体现医保人利民为民情怀的“实验场”，是检验医保工作水平的“试金石”</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">做好城乡居民医保参保</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">缴费</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">工作</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">的同时，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">精准界定</font>“两病”保障对象范围，</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">确保待遇到人，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">对已纳入门诊慢性病保障范围的进行系统精准识别，确保待遇不降。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 方正楷体_GBK; mso-hansi-font-family: 方正楷体_GBK; mso-ascii-font-family: 方正楷体_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（四）加强基金监管，维护基金安全。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">建立健全隆阳区医疗保险内部控制制度及隆阳区医疗保障局内部控制细则，将责任明确到各经办人员，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强医保经办的城镇职工、城乡居民医疗保险各项业务、各个环节进行全过程控制的监督，提高医疗保险法律、法规、各项规章制度和两定机构《服务协议》的执行力度，保证医疗保险参保征缴的目标任务、医保基金的安全完整，维护参保人员的合法权益。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">开展内控制度成效评估，加强内部稽核，维持基金安全平稳运行，对超指标定点医疗机构进行约谈，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强对</font>“两定”医疗机构的日常监管及稽核管理，开展专项整治“回头看”及扶贫领域医疗费用全面核查工作，加大查处力度，严厉打击欺诈骗保，坚决维护基金安全。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 28pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; text-autospace: ideograph-numeric; padding-top: 0pt; mso-pagination: none; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（五）</font></span><span style="font-family: 方正楷体_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">加强支付方式改革</font></span><b><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span></b><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">根据市医疗保障局部署安排</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">加快推进</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">分级诊疗和</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">DRGs付费方式改革，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">实施医疗保险基金总额控制，在基金测算阶段确保</font>“以收定支，收支平衡，略有结余”的基金管理原则，通过总额控制促使医疗机构提效率、降成本，减少不合理医疗等管理手段来控制医疗费用的过快增长。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-align: left; line-height: 28pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（六）强化党风廉政建设工作。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">落实中央八项规定精神，加强日常自查自纠，持之以恒纠正四风，领导班子带头坚持身体力行，发挥</font>“关键少数”示范带动作用，形成“头雁效应”。加强医疗保障行风建设，加强组织领导，细化工作方案，明确工作进度、具体措施、方法步骤、责任分工，推进行风建设</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">积极推动建立作风建设长效机制、不断加强组织领导，把作风建设作为重要工作，作为服务和保障改善民生，深化医保领域改革，提升医保贡献率、群众满意度和获得感的重要抓</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强完善各项规章制度，强化内控管理，加强内部组织机构、业务运行控制、基金财务控制、信息系统管理、内部控制的管理与监督</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 27pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; padding-top: 0pt; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 28pt; text-indent: 21pt; padding-left: 0pt; padding-right: 0pt; text-autospace: ideograph-numeric; padding-top: 0pt; mso-pagination: none; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 10.5pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri; mso-ascii-font-family: Calibri">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 240pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 15.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区医疗保障局</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 240pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 15.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">11</font><font face="方正仿宋_GBK">月</font><font face="宋体">12</font><font face="方正仿宋_GBK">日</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Calibri; font-size: 10.5pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 宋体; mso-bidi-font-family: 'Times New Roman'">
<o:p>
</o:p></span></p>
</div>
<!--EndFragment-->
@font-face{
font-family:"Times New Roman";}
@font-face{
font-family:"宋体";}
@font-face{
font-family:"Calibri";}
@font-face{
font-family:"Wingdings";}
@font-face{
font-family:"黑体";}
@font-face{
font-family:"方正小标宋_GBK";}
@font-face{
font-family:"方正仿宋_GBK";}
@font-face{
font-family:"方正黑体_GBK";}
@font-face{
font-family:"方正楷体_GBK";}
@font-face{
font-family:"仿宋_GB2312";}
@list l0:level1{
mso-level-number-format:chinese-counting;
mso-level-suffix:none;
mso-level-text:"（%1）";
mso-level-tab-stop:none;
mso-level-number-position:left;
margin-left:0.0000pt;
text-indent:0.0000pt;
font-family:宋体;}
p.MsoNormal{
mso-style-name:正文;
mso-style-parent:"";
mso-style-next:"table of figures";
margin:0pt;
margin-bottom:.0001pt;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
span.10{
font-family:Calibri;}
p.p{
mso-style-name:"普通\(网站\)";
margin-top:5.0000pt;
margin-bottom:5.0000pt;
mso-margin-top-alt:auto;
mso-margin-bottom-alt:auto;
mso-pagination:none;
text-align:left;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:12.0000pt;}
p.MsoHeader{
mso-style-name:页眉;
margin:0pt;
margin-bottom:.0001pt;
border-top:none;
mso-border-top-alt:none;
border-right:none;
mso-border-right-alt:none;
border-bottom:none;
mso-border-bottom-alt:none;
border-left:none;
mso-border-left-alt:none;
padding:1pt 4pt 1pt 4pt ;
layout-grid-mode:char;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:9.0000pt;
mso-font-kerning:1.0000pt;}
p.MsoFooter{
mso-style-name:页脚;
margin:0pt;
margin-bottom:.0001pt;
layout-grid-mode:char;
mso-pagination:none;
text-align:left;
font-family:Calibri;
mso-fareast-font-family:宋体;
mso-bidi-font-family:'Times New Roman';
font-size:9.0000pt;
mso-font-kerning:1.0000pt;}
p.18{
mso-style-name:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
mso-style-next:"table of figures";
margin:0pt;
margin-bottom:.0001pt;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:'Times New Roman';
mso-fareast-font-family:宋体;
mso-bidi-font-family:黑体;
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
p.19{
mso-style-name:"table of figures";
mso-style-parent:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
mso-style-next:"正文 New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New New";
margin-left:10.0000pt;
mso-para-margin-left:2.0000gd;
text-indent:-10.0000pt;
mso-char-indent-count:-2.0000;
mso-pagination:none;
text-align:justify;
text-justify:inter-ideograph;
font-family:'Times New Roman';
mso-fareast-font-family:宋体;
mso-bidi-font-family:黑体;
font-size:10.5000pt;
mso-font-kerning:1.0000pt;}
span.msoIns{
mso-style-type:export-only;
mso-style-name:"";
text-decoration:underline;
text-underline:single;
color:blue;}
span.msoDel{
mso-style-type:export-only;
mso-style-name:"";
text-decoration:line-through;
color:red;}
table.MsoNormalTable{
mso-style-name:普通表格;
mso-style-parent:"";
mso-style-noshow:yes;
mso-tstyle-rowband-size:0;
mso-tstyle-colband-size:0;
mso-padding-alt:0.0000pt 5.4000pt 0.0000pt 5.4000pt;
mso-para-margin:0pt;
mso-para-margin-bottom:.0001pt;
mso-pagination:widow-orphan;
font-family:'Times New Roman';
font-size:10.0000pt;
mso-ansi-language:#0400;
mso-fareast-language:#0400;
mso-bidi-language:#0400;}
@page{mso-page-border-surround-header:no;
mso-page-border-surround-footer:no;}@page Section0{
margin-top:72.0000pt;
margin-bottom:72.0000pt;
margin-left:90.0000pt;
margin-right:90.0000pt;
size:595.3000pt 841.9000pt;
layout-grid:15.6000pt;}
div.Section0{page:Section0;}</style>
<!--StartFragment-->
<div class="Section0" style="layout-grid: 15.6pt none">
<p class="MsoNormal" align="center" style="text-align: center"><span style="font-family: 方正小标宋_GBK; font-size: 22pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正小标宋_GBK">隆阳区医保部门</font>2019年度工作总结</span><span style="font-family: 方正小标宋_GBK; font-size: 22pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<!--?xml:namespace prefix="o" /-->
<!--?xml:namespace prefix="o" /-->
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="text-align: left; line-height: 27pt; text-indent: 32pt; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">在</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">区委区政府</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">的正确领导下，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">在市医疗保障局的指导帮助下，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">按照</font>“保基本、可持续、惠民生、推改革”的总体要求，把握形势、厘清思路、强化履职，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">推进隆阳医疗保障事业高质量跨越发展，现将一年来的工作汇报如下：</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">一、</font>2019年度工作取得的成绩</span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly; mso-list: l0 level1 lfo1"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><span style="mso-list: Ignore">（一）</span></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">参保征缴及基金收支情况</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span></b><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">参保目标完成情况</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年隆阳区医疗保险参保人数达</font><font face="宋体">88.49</font><font face="方正仿宋_GBK">万人，其中：职工医疗保险参保人数为</font><font face="宋体">3.94</font><font face="方正仿宋_GBK">万人，城乡居民医疗保险参保人数</font><font face="宋体">84.55</font><font face="方正仿宋_GBK">万人。参保人员中，</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年度全区建档立卡贫困人口共</font><font face="宋体">93980</font><font face="方正仿宋_GBK">人，已实现</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参加基本医疗保险及大病补充医疗保险。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.<font face="方正仿宋_GBK">医保基金收支情况</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>1<font face="方正仿宋_GBK">）城乡居民医保基金收支情况。</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年城乡居民</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">按参保人数应筹集资金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">62565.52</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：个人参保缴费标准</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">220</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>/<font face="方正仿宋_GBK">人</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，合计</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">845480</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人</font>×</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">220</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>=</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">18600.56</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元；各级财政补助</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">520</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>/<font face="方正仿宋_GBK">人</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，合计</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">845480</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人</font>×</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">520</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">元</font>=</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">43964.96</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。截至</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">10</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">月</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">24</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">日实际筹集资金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">61196.38</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，资金到位率为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">97.81%<font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">其</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">中：个人参保缴费实际收缴</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">17838.85</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元（与应筹集资金存在差异是因为财政代缴部份尚未到位）</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">；</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">各级财政补助到位</font>43357.53<font face="方正仿宋_GBK">万元</font><font face="宋体">(</font><font face="方正仿宋_GBK">中央财政补助资金</font><font face="宋体">34564.44</font><font face="方正仿宋_GBK">万元，省级财政补助到位</font><font face="宋体">7477.13</font><font face="方正仿宋_GBK">万元，市级财政补助到位</font><font face="宋体">274.56</font><font face="方正仿宋_GBK">万元，区级财政补助</font><font face="宋体">1041.40</font><font face="方正仿宋_GBK">万元</font><font face="宋体">,</font><font face="方正仿宋_GBK">），实际人均财政补助到位</font><font face="宋体">512.82</font><font face="方正仿宋_GBK">元</font><font face="宋体">/</font><font face="方正仿宋_GBK">人（中央补助尚未到位</font><font face="宋体">607.53</font><font face="方正仿宋_GBK">万元），完成比例</font><font face="宋体">98.62%</font><font face="方正仿宋_GBK">，利息收入</font><font face="宋体">42.27</font><font face="方正仿宋_GBK">万元（因基金实行市级统筹，个人缴费资金及财政补助资金按规定按时上解市级，故利息收入较上年大幅减少）。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>2<font face="方正仿宋_GBK">）城镇职工医保基金收支情况。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">征收职工医疗保险金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">16940</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：基本医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">12020</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，大病补充医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">814</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，公务员医疗补助</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">4106</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。支付医疗基金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">13103</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，其中：支付基本医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">8005</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元；支付公务员医疗补助基金</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">5098</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。全区参加离休人员医疗统筹的单位有</font>49 <font face="方正仿宋_GBK">个，参保人数为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">52</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人，离休人员医疗保障基金收入</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">39</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元，支出</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">153</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）异地就医结算情况。截至</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，异地就医零星报账结算审核人次</font><font face="宋体">6545</font><font face="方正仿宋_GBK">人次，统筹基金支付</font><font face="宋体">641.13</font><font face="方正仿宋_GBK">万元。其中：城镇职工住院手工结算</font><font face="宋体">156</font><font face="方正仿宋_GBK">人次，特慢病门诊</font><font face="宋体">185</font><font face="方正仿宋_GBK">人次，统筹基金支付</font><font face="宋体">245.43</font><font face="方正仿宋_GBK">万元，大病医保基金支付</font><font face="宋体">625.53</font><font face="方正仿宋_GBK">万元；城乡居民异地结算</font><font face="宋体">5725</font><font face="方正仿宋_GBK">人次，特慢病门诊</font><font face="宋体">479</font><font face="方正仿宋_GBK">人次。统筹基金支付</font><font face="宋体">3253.6</font><font face="方正仿宋_GBK">万元，大病保险支付</font><font face="宋体">1392.04</font><font face="方正仿宋_GBK">万元，医疗救助补助</font><font face="宋体">56.02</font><font face="方正仿宋_GBK">万元，兜底资金补助</font><font face="宋体">36.6</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>4<font face="方正仿宋_GBK">）定点医疗机构医疗保障基金清算情况。根据《保山市医疗保险服务中心关于对</font><font face="宋体">2018</font><font face="方正仿宋_GBK">年度城乡居民医疗保险超支分担及城镇职工医疗保险超支清算的通知》（保医保中心</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）文件要求，结合我区实际情况，我局制定了《</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2018<font face="方正仿宋_GBK">年度隆阳区医疗保障基金清算方案》，当年基金超支</font><font face="宋体">3%</font><font face="方正仿宋_GBK">以内的（按当年实际收入计算，全额</font><font face="宋体">3%</font><font face="方正仿宋_GBK">），由市级动用历年结余全额调剂，基金超支</font><font face="宋体">3%</font><font face="方正仿宋_GBK">—</font><font face="宋体">5%</font><font face="方正仿宋_GBK">（含</font><font face="宋体">5%</font><font face="方正仿宋_GBK">）的部分，由市级调剂补助</font><font face="宋体">50%</font><font face="方正仿宋_GBK">，县（市、区）承担</font><font face="宋体">50%</font><font face="方正仿宋_GBK">；基金超支</font><font face="宋体">5%</font><font face="方正仿宋_GBK">以上的部分由县（市、区）级承担。隆阳区</font><font face="宋体">2018</font><font face="方正仿宋_GBK">年基金收入</font><font face="宋体">56857.62</font><font face="方正仿宋_GBK">万元，全年超指标</font><font face="宋体">13180</font><font face="方正仿宋_GBK">万元，全年结算后剩余</font><font face="宋体">6154</font><font face="方正仿宋_GBK">万元，超支基金</font><font face="宋体">7024.57</font><font face="方正仿宋_GBK">万元，超支</font><font face="宋体">12%</font><font face="方正仿宋_GBK">，市级承担</font><font face="宋体">3%</font><font face="方正仿宋_GBK">承担金额</font><font face="宋体">1706</font><font face="方正仿宋_GBK">万元。完成隆阳区城乡居民医疗保险指标内清算合计</font><font face="宋体">1169.19</font><font face="方正仿宋_GBK">万元，超指标清算</font><font face="宋体">7266.74</font><font face="方正仿宋_GBK">万元；城镇职工医疗保险基金指标内清算合计</font><font face="宋体">594.5</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-indent: 29.6pt; mso-char-indent-count: 1.8500"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">（</font>5<font face="方正仿宋_GBK">）医疗救助工作开展情况。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">截止</font>10月20日，</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">个人缴费</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">直接</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">资助</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">建档立卡贫困户</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">93980</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">人，金额</font>912</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">6</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">4万</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；城镇低保户</font>6881户12097人，金额143</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">06</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；农村低保户</font>17744户21761人，金额261</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">13</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元；特困户</font>2438户3413人，无主精神病人138人，金额78</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">12</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。住院</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">医疗</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">救助</font>9738人次，支付医疗救助资金1189</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">0</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">7</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。其中建档立卡贫困人口</font>6509人次，金额722</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">67元；城乡低保特困人口3229人次，金额466</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">.</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri">4</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">万</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri"><font face="仿宋_GB2312">元。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（二）</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正楷体_GBK">年重点工作完成情况</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">压实医保扶贫责任，助力全区脱贫攻坚工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">落实建档立卡人员医保倾斜待遇。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">严格按照《云南省健康扶贫</font>30<font face="方正仿宋_GBK">条措施》及有关政策要求，提高贫困人口基本医疗、大病保险报销比例</font><font face="宋体">10%</font><font face="方正仿宋_GBK">至</font><font face="宋体">20%</font><font face="方正仿宋_GBK">，降低大病报销起付线及提高大病保险报销上限各</font><font face="宋体">50%</font><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">开展贫困人员数据动态管理，将新识别的贫困人口已缴纳</font> <font face="方正仿宋_GBK">参保费用</font>220<font face="方正仿宋_GBK">元的，给予每人</font><font face="宋体">180</font><font face="方正仿宋_GBK">元的退款，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">合计退款</font>312<font face="方正仿宋_GBK">人次</font><font face="宋体">56160</font><font face="方正仿宋_GBK">元。对个人缴费</font><font face="宋体">40</font><font face="方正仿宋_GBK">元，财政代缴</font><font face="宋体">180</font><font face="方正仿宋_GBK">元被剔除贫困户的人员，补收财政代缴</font><font face="宋体">180</font><font face="方正仿宋_GBK">元，经动员不缴费参保的，退回个人缴费部分</font><font face="宋体">40</font><font face="方正仿宋_GBK">元，取消</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年度的参保，合计退款</font><font face="宋体">187</font><font face="方正仿宋_GBK">人</font><font face="宋体">7480</font><font face="方正仿宋_GBK">元。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">保障建档立卡贫困人口正常享受医疗保险待遇。截至</font>2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，全区建档立卡贫困人员住院</font><font face="宋体">16196</font><font face="方正仿宋_GBK">人次，总费用</font><font face="宋体">7817.18</font><font face="方正仿宋_GBK">万元，基本医疗报销</font><font face="宋体">5408.77</font><font face="方正仿宋_GBK">万元，大病保险报销</font><font face="宋体">440.15</font><font face="方正仿宋_GBK">万元，医疗救助</font><font face="宋体">811.72</font><font face="方正仿宋_GBK">万元，兜底保障</font><font face="宋体">267.5</font><font face="方正仿宋_GBK">万元，实际补偿比例达</font><font face="宋体">88.63%</font><font face="方正仿宋_GBK">，其中符合转诊转院规范的实际报销比为</font><font face="宋体">91.65%</font><font face="方正仿宋_GBK">，不符合转诊转院规范的实际报销比为</font><font face="宋体">45.6%</font><font face="方正仿宋_GBK">，有效防止了因病致贫返贫。门诊就诊</font><font face="宋体">229055</font><font face="方正仿宋_GBK">人次，医疗总费用</font><font face="宋体">807.1</font><font face="方正仿宋_GBK">万元，报销</font><font face="宋体">425.97</font><font face="方正仿宋_GBK">万元，报销比例</font><font face="宋体">52.78%</font><font face="方正仿宋_GBK">；特慢病门诊就诊</font><font face="宋体">7842</font><font face="方正仿宋_GBK">人次，总费用</font><font face="宋体">295.19</font><font face="方正仿宋_GBK">万元，报销</font><font face="宋体">236.03</font><font face="方正仿宋_GBK">万元，政策范围内报销比例</font><font face="宋体">82.04%</font><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">2.完成机构改革职能划转工作</span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成医保征管职责划转工作。如期完成城镇职工、城乡居民征管职能整体划转税务，确保了划转过渡期医疗保险征缴工作可持续、不间断，实现与税务部门数据实时交互，确保参保人员的政策待遇不受影响。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成医疗救助接续工作。根据机构改革职能划转及《保山市医疗保障局</font> <font face="方正仿宋_GBK">保山市民政局关于医疗救助交接有关事宜的通知》（医保电</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）等文件要求，医疗救助相关工作由区民政局按职能划转移交给区医疗保障局，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">6</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式移交。截至</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">31</font><font face="方正仿宋_GBK">日，医疗救助财政专户资金实际支付</font><font face="宋体">813.04</font><font face="方正仿宋_GBK">万元，结余</font><font face="宋体">470.41</font><font face="方正仿宋_GBK">万元；年初预算城乡医疗救助剩余指标金额</font><font face="宋体">370</font><font face="方正仿宋_GBK">万元，中央专项彩票公益金剩余指标金额</font><font face="宋体">103.8</font><font face="方正仿宋_GBK">万元。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完成职工生育保险接续工作。职工生育保险相关工作由人社局按职能划转移交给区医疗保障局，</font>2019<font face="方正仿宋_GBK">年</font><font face="宋体">10</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式移交。</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt"><font face="方正仿宋_GBK">完成定点医药机构服务协议签订工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">20</font><font face="方正仿宋_GBK">日至</font><font face="宋体">22</font><font face="方正仿宋_GBK">日，我局分别与</font><font face="宋体">49</font><font face="方正仿宋_GBK">家定点医疗机构进行了医疗服务协议谈判与签订工作。《</font><font face="宋体">2019</font><font face="方正仿宋_GBK">年保山市医疗保险定点医疗机构服务协议》最大的亮点在于：甲方（医疗保障局）根据本统筹区医保基金收支预算情况，按照《保山市基本医疗保险总额控制管理暂行办法》对乙方（定点医疗机构）的年度医保付费实行总额控制。不仅提高基本医疗保险基金的使用效率，建立定点医疗机构主动控费机制，更有效控制了医疗费用不合理增长，确保基本医疗保险制度的可持续发展，是隆阳区结合实际，以医保基金收支预算管理为前提，以在线即时结算为基础，以保障参保人员基本医疗需求为目标，根据“以收定支、收支平衡、略有结余”的原则，实行“总额控制、按月结算、年终清算、结余留用、合理超支分担”的结算办法。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-fareast-font-family: 方正楷体_GBK; mso-bidi-font-family: 方正楷体_GBK">
<o:p></o:p></span></p>
<p class="p" style="line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">4.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt"><font face="方正仿宋_GBK">落实分级诊疗制度</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">根据《保山市医疗保障局关于完善城乡居民医疗保险转诊转院有关工作的通知》（保医保</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〔</font>201</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">〕</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">9</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">号</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">）文件精神，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">按照</font>2020<font face="方正仿宋_GBK">年争取形成“基层首诊、双向转诊、急慢分治、上下联动”为核心的较为完善的分级诊疗模式，基本实现“小病不出村、常见病不出乡、大病不出县、急危重症和疑难杂症不出市、康复在基层”的要求，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区于</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">5</font><font face="方正仿宋_GBK">月</font><font face="宋体">1</font><font face="方正仿宋_GBK">日正式实施分级诊疗制度。严格按照市级文件要求对未按转诊转院规范进行诊治的，其医疗费（含大病保险费用）在正常报销比例的基础上，分别下调了</font><font face="宋体">10</font><font face="方正仿宋_GBK">个百分点。</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">截至</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">2019</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">年</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">10</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">月全区</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">居民：</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">累计转诊患者</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">10082</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，其中由基层转诊到区级医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">47</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到区外市内医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">8957</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到省级或省外医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">966</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">，转到省内异地就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">159</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。由区级医院转诊到基层医院进行康复治疗</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">11</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人。</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">职工：</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">累计转诊患者</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">606</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到区外市内医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">23</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人，转到省级或省外医院就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">515</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">，转到省内异地就诊</font></span><span style="font-family: 宋体; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt">68</span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">人</font></span><span style="font-family: 仿宋_GB2312; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-bidi-font-family: 宋体; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">5.<font face="方正仿宋_GBK">完成城镇职工门诊慢性病待遇支付扩大至零售药店试点工作</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">为方便门诊慢性病参保患者就医购药和费用结算，不断提高医疗保障管理服务水平，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">将城镇职工基本医疗保险门诊慢性病待遇支付扩大至零售药店。结合隆阳实际，坚持公开、公平、公正的原则及坚持总量控制、区域限制、比选择优的原则，通过</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">制定评审方案</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，对符合条件且愿承担门诊慢性病售药服务的定点药店组织专家评估和实地考察综合评估，并将结果公示</font>7</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">个工作日</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，最终在主城内确定</font>18<font face="方正仿宋_GBK">家定点药店为“城镇职工门诊慢性病待遇支付定点药店”</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">6.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">落实稽核职责，维护基金安全见实效</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。为强化基金监管，对定点医药机构全面稽核，开展定点医药机构专项治理工作，制定《隆阳区医疗保障局开展定点医药机构专项治理工作方案》《隆阳区</font>2019<font face="方正仿宋_GBK">年打击欺诈骗保专项行动月工作方案》，以开展专项治理为契机，逐一排查全区定点医药机构的违法违规行为，实现对定点医药机构的稽核稽查全覆盖。截止</font><font face="宋体">10</font><font face="方正仿宋_GBK">月，通过人工、智能审核城镇职工医保查处定点医疗机构</font><font face="宋体">32</font><font face="方正仿宋_GBK">家，扣回医保基金</font><font face="宋体">8.7</font><font face="方正仿宋_GBK">万元，城乡居民医保查处定点医疗机构</font><font face="宋体">50</font><font face="方正仿宋_GBK">家，扣回医保基金</font><font face="宋体">18.96</font><font face="方正仿宋_GBK">万元。通过</font><font face="宋体">9</font><font face="方正仿宋_GBK">月份对医药机构专项治理，对辖区内</font><font face="宋体">50</font><font face="方正仿宋_GBK">家定点医药机构进行全面核查，</font></span><span style="font-family: 方正仿宋_GBK; letter-spacing: 0.7pt; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">共追回违规资金</font>(<font face="方正仿宋_GBK">含大病审核拒付</font><font face="宋体">)769.6</font><font face="方正仿宋_GBK">万元。</font></span><span style="font-family: 方正仿宋_GBK; letter-spacing: 0.7pt; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 27pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; padding-top: 0pt; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">7</span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">.</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">推进作风建设，紧抓主题教育</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">成立主题教育领导小组及办公室，制定《</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">隆阳区</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">医疗保障局开展</font>“不忘初心、牢记使命”主题教育</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">工作</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">方案》，把学习教育、调查研究、检视问题、整改落实有机融合、贯穿始终。召开</font>“不忘初心、牢记使命”主题教育启动会议，明确守初心、担使命、找差距、抓落实的总要求。制定主题教育学习计划，采取自学和集中学习方式，读原著、学原文、悟原理。围绕党的政治建设、全面从严治党、理想信念、宗旨性质、担当作为、政治纪律和政治规矩、党性修养、廉洁自律等8个专题，扎实开展集中研讨。坚持问题导向，聚焦医疗保障，围绕“党的建设、医疗保障脱贫攻坚、医保基金管理使用、窗口作风建设、医疗保障政策以及医疗服务价格调整、医疗保障基金运行和打击医保基金欺诈骗保”等6个方面调研主题，着力解决医保工作中的瓶颈问题。制定对照党章党规查找差距的工作方案，在原原本本学习《中国共产党党内重要法规汇编》，《中国共产党章程》《准则》《条例》的基础上，组织局党组班子成员、普通党员，从思想、政治、作风、能力、廉政方面自觉对照习近平新时代中国特色社会主义思想，对照“十八个是否”，多种形式找差距、查短板。制定专项整治的工作方案，把“改”字贯穿始终，逐一对照可问题开展专项整治，坚持边学边整改、边调研边整改、边检视边整改，确保整改以取得实效。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（三）</font>2019年本部门工作亮点</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">医保付费实行总额控制</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于：甲方（医疗保障局）根据本统筹区医保基金收支预算情况，按照《保山市基本医疗保险总额控制管理暂行办法》对乙方（定点医疗机构）的年度医保付费实行总额控制。不仅提高基本医疗保险基金的使用效率，建立定点医疗机构主动控费机制，更有效控制了医疗费用不合理增长，确保基本医疗保险制度的可持续发展。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">实行分级诊疗制度</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于差异化支付政策，对未按转诊转院规范进行诊治的（特殊情况除外），其医药费（含大病保险费）在正常报销比例的基础上，分别下调</font>10<font face="方正仿宋_GBK">个百分点。形成基层首诊、双向转诊、急慢分治、上下联动的分级诊疗模式。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">3.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">门诊慢性病待遇支付扩大至定点药店</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。最大的亮点在于</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">推进基本医疗保险支付方式</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">的</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">改革</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">坚持合理布点</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">方便购药、自由选择的原则</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，方</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">便门诊慢性病参保患者就医购药和费用结算</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">提高医疗</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">保障</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">管理服务水平</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">二、存在问题及短板</font></span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-shading: rgb(255,255,255)"><font face="方正楷体_GBK">（一）医保基金监管存在的问题</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">稽核</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">人员配备不足。</font>2019<font face="方正仿宋_GBK">年隆阳区医疗保险参保人数达</font><font face="宋体">88.49</font><font face="方正仿宋_GBK">万人，承担辖区内</font><font face="宋体">49</font><font face="方正仿宋_GBK">家定点医疗机构及</font><font face="宋体">239</font><font face="方正仿宋_GBK">家定点药店医保基金监管工作，监管工作任务较重。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">跨省异地住院稽查难度较大</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">建议进一步完善跨省异地直接结算平台，既方便参保群众，又有效防止参保人员在外地虚开住院发票骗取套取医保基金的行为发生</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">承担意外伤害核查工作，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="仿宋_GB2312">意外伤害住院产生欺诈骗保情况较多，建议与公安、卫健、市场监管等部门建立协同机制，定期交换参保患者交通事故处理情况。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">四是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">机构改革后又新增</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">划入</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">了职能职责，但相关部门未转隶人员到我局，所有划转工作职责需现有</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">人员承担</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">，一人多责。</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)">
<o:p></o:p></span></p>
<p class="p" align="justify" style="text-justify: inter-ideograph; text-align: justify; line-height: 27pt; margin-top: 0pt; text-indent: 32pt; margin-bottom: 0pt; background: rgb(255,255,255); mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-shading: rgb(255,255,255)"><font face="方正楷体_GBK">（二）信息化系统存在问题</font></span><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">一是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">数据共享存在时间差。税务部门与医保部门信息系统数据部能实时对接，导致医保征收进度受影响，基层征缴人员征收工作缓慢推进。</font></span><b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">二是</font></span></b><span style="font-family: 方正仿宋_GBK; background: rgb(255,255,255); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体; mso-shading: rgb(255,255,255)"><font face="方正仿宋_GBK">在执行</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">档立卡等特殊待遇时，仅依靠其他部门提供数据后比对，部分信息无法比对的只能依靠人工核实进行标记导致政策执行存在滞后；参保人员的状态变化因数据不共享导致享受待遇过多或不足，基金追回或补差甚为困难。</font></span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">三</font></span></b><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">是</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">异地结算联网直接结算存在因网络延迟数据异常导致无法正常结算的问题</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正黑体_GBK">三、</font>2020年工作计划</span><span style="font-family: 方正黑体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（一）继续做好医保扶贫工作。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">紧紧围绕</font>“两不愁、三保障”做好医疗保障工作。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">完善建档立卡人口参保管理、动态管理，确保建档立卡贫困人口</font>100%<font face="方正仿宋_GBK">参保并享受基本医疗、大病保险，符合条件的享受医疗救助的倾斜政策。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（二）继续加强医保基金的管理工作。</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">1</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">.<font face="方正仿宋_GBK">配合税务部门做好</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2020</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">年参保征缴工作</font></span></b><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">城乡居民征缴工作移交税务部门代征，我局将全面配合税务部门启动</font>2020<font face="方正仿宋_GBK">年医保征缴工作，完成参保任务，加大政策宣传，扩大参保面，在确保建档立卡贫困户</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参保的同时，力争全区城乡居民</font><font face="宋体">100%</font><font face="方正仿宋_GBK">参加城乡居民医疗保险及大病医疗保险，有效防止因病返贫、因病致贫。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="19" style="text-indent: 32pt; text-autospace: ideograph-numeric; margin-left: 0pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2.</span><b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">签订服务协议，加强基金管理工作。</font></span></b><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">实行医保基金总额控制政策，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">根据</font>“以收定支、收支平衡、略有结余”的原则，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">与定点医药机构签订</font>2020<font face="方正仿宋_GBK">年医保服务协议，制定清算方案，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">定期进行基金运行情况分析</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">对</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">费用控制指标使用率较高，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">就诊人次异常增长的定点医疗机构，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">重点稽核，发现</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">套取医保基金的违规行为</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，按照相关规定</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">严管重</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">处</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 'Times New Roman'; font-size: 10.5pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 宋体; mso-bidi-font-family: 黑体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（三）加大分级诊疗政策宣传力度。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">围绕</font>“小病不出村、常见病不出乡、大病不出县”的要求，加大分级诊疗宣传力度，扩宽宣传渠道。将我局制作的<font face="宋体">MP3</font><font face="方正仿宋_GBK">、动漫视频、宣传单、折页及海报发放到各乡镇（街道）、村（社区）要求循环播放，并在醒目处粘贴海报；并要求各定点医疗机构对住院患者进行宣传，将政策宣传单发放到各科室，明确各科室宣传责任人，由各科室对在院患者进行宣传解读，将各医疗机构宣传力度纳入医保日常考核指标中。充分发挥县、乡、村三级医疗资源，认真落实分级诊疗转诊转院制度，自下而上解决疑难杂症、自上而下开展康复治疗，逐步形成“基层首诊、上下结合”的医疗体系。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="19" style="line-height: 28pt; text-indent: 32pt; text-autospace: ideograph-numeric; margin-left: 0pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（四）</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"> </span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">完善</font></span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">“两病”门诊用药保障</span><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">机制。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">完善</font>“两病”门诊用药保障机制，是体现医保人利民为民情怀的“实验场”，是检验医保工作水平的“试金石”</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">做好城乡居民医保参保</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">缴费</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">工作</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">的同时，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">精准界定</font>“两病”保障对象范围，</span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">确保待遇到人，</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="仿宋_GB2312">对已纳入门诊慢性病保障范围的进行系统精准识别，确保待遇不降。</font></span><span style="font-family: 仿宋_GB2312; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 方正楷体_GBK; mso-hansi-font-family: 方正楷体_GBK; mso-ascii-font-family: 方正楷体_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正楷体_GBK">（四）加强基金监管，维护基金安全。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">建立健全隆阳区医疗保险内部控制制度及隆阳区医疗保障局内部控制细则，将责任明确到各经办人员，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强医保经办的城镇职工、城乡居民医疗保险各项业务、各个环节进行全过程控制的监督，提高医疗保险法律、法规、各项规章制度和两定机构《服务协议》的执行力度，保证医疗保险参保征缴的目标任务、医保基金的安全完整，维护参保人员的合法权益。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">开展内控制度成效评估，加强内部稽核，维持基金安全平稳运行，对超指标定点医疗机构进行约谈，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强对</font>“两定”医疗机构的日常监管及稽核管理，开展专项整治“回头看”及扶贫领域医疗费用全面核查工作，加大查处力度，严厉打击欺诈骗保，坚决维护基金安全。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 28pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; text-autospace: ideograph-numeric; padding-top: 0pt; mso-pagination: none; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（五）</font></span><span style="font-family: 方正楷体_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">加强支付方式改革</font></span><b><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: bold; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">。</font></span></b><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; font-weight: normal; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">根据市医疗保障局部署安排</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">加快推进</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">分级诊疗和</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">DRGs付费方式改革，</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">实施医疗保险基金总额控制，在基金测算阶段确保</font>“以收定支，收支平衡，略有结余”的基金管理原则，通过总额控制促使医疗机构提效率、降成本，减少不合理医疗等管理手段来控制医疗费用的过快增长。</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="text-align: left; line-height: 28pt; text-indent: 32pt; text-autospace: ideograph-numeric; mso-pagination: none; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正楷体_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正楷体_GBK">（六）强化党风廉政建设工作。</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">落实中央八项规定精神，加强日常自查自纠，持之以恒纠正四风，领导班子带头坚持身体力行，发挥</font>“关键少数”示范带动作用，形成“头雁效应”。加强医疗保障行风建设，加强组织领导，细化工作方案，明确工作进度、具体措施、方法步骤、责任分工，推进行风建设</span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">积极推动建立作风建设长效机制、不断加强组织领导，把作风建设作为重要工作，作为服务和保障改善民生，深化医保领域改革，提升医保贡献率、群众满意度和获得感的重要抓</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">，</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">加强完善各项规章制度，强化内控管理，加强内部组织机构、业务运行控制、基金财务控制、信息系统管理、内部控制的管理与监督</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">。</font></span><span style="font-family: 方正仿宋_GBK; color: rgb(0,0,0); font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 0.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 27pt; text-indent: 32pt; padding-left: 0pt; padding-right: 0pt; padding-top: 0pt; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="border-bottom: rgb(255,255,255) 1pt solid; padding-bottom: 31pt; line-height: 28pt; text-indent: 21pt; padding-left: 0pt; padding-right: 0pt; text-autospace: ideograph-numeric; padding-top: 0pt; mso-pagination: none; mso-border-bottom-alt: 0.5000pt solid rgb(255,255,255); mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 10.5pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-bidi-font-family: 'Times New Roman'; mso-hansi-font-family: Calibri; mso-ascii-font-family: Calibri">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 32pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 2.0000; mso-line-height-rule: exactly"><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p>
</o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 240pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 15.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体"><font face="方正仿宋_GBK">隆阳区医疗保障局</font></span><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height: 27pt; text-indent: 240pt; mso-pagination: none; mso-para-margin-left: 0.0000gd; mso-char-indent-count: 15.0000; mso-line-height-rule: exactly"><span style="font-family: 方正仿宋_GBK; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-hansi-font-family: 宋体; mso-ascii-font-family: 宋体">2019<font face="方正仿宋_GBK">年</font><font face="宋体">11</font><font face="方正仿宋_GBK">月</font><font face="宋体">12</font><font face="方正仿宋_GBK">日</font></span><span style="font-family: 宋体; font-size: 16pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 方正仿宋_GBK; mso-bidi-font-family: 方正仿宋_GBK">
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Calibri; font-size: 10.5pt; mso-spacerun: 'yes'; mso-font-kerning: 1.0000pt; mso-fareast-font-family: 宋体; mso-bidi-font-family: 'Times New Roman'">
<o:p>
</o:p></span></p>
</div>
<!--EndFragment-->
滇公网安备 53050202000027号