每日一词∣医保基金监管制度体系 supervision system for the healthcare security fund
<p>国务院办公厅日前印发《关于推进医疗保障基金监管制度体系改革的指导意见》。《意见》要求，到2025年，基本建成医保基金监管制度体系和执法体系。要推进监管制度体系改革，建立智能监控、举报奖励、信用管理制度，完善社会监督制度。</p><p><span word="The">The</span> <span word="General">General</span> <span word="Office">Office</span> <span word="of">of</span> <span word="the">the</span> <span word="State">State</span> <span word="Council">Council</span> <span word="has">has</span> <span word="recently">recently</span> <span word="released">released</span> <span word="a">a</span> <span word="guideline">guideline</span>, <span word="stressing">stressing</span> <span word="the">the</span> <span word="reform">reform</span> <span word="of">of</span> <span word="the">the</span> <span word="supervision">supervision</span> <span word="system">system</span> <span word="for">for</span> <span word="the">the</span> <span word="healthcare">healthcare</span> <span word="security">security</span> <span word="fund">fund</span>. <span word="The">The</span> <span word="supervision">supervision</span> <span word="and">and</span> <span word="law">law</span> <span word="enforcement">enforcement</span> <span word="systems">systems</span> <span word="for">for</span> <span word="the">the</span> <span word="fund">fund</span> <span word="will">will</span> <span word="be">be</span> <span word="basically">basically</span> <span word="in">in</span> <span word="place">place</span> <span word="by">by</span> <span word="the">the</span> <span word="year">year</span> 2025, <span word="read">read</span> <span word="the">the</span> <span word="document">document</span>. <span word="Urging">Urging</span> <span word="the">the</span> <span word="promotion">promotion</span> <span word="of">of</span> <span word="reform">reform</span>, <span word="it">it</span> <span word="requires">requires</span> <span word="building">building</span> <span word="the">the</span> <span word="systems">systems</span> <span word="for">for</span> <span word="smart">smart</span> <span word="supervision">supervision</span>, <span word="tip">tip</span>-<span word="off">off</span> <span word="rewards">rewards</span> <span word="and">and</span> <span word="credit">credit</span> <span word="management">management</span>, <span word="and">and</span> <span word="improving">improving</span> <span word="the">the</span> <span word="system">system</span> <span word="for">for</span> <span word="public">public</span> <span word="supervision">supervision</span>.</p><p> 上海市胸科医院，一名患者正在取药。医疗保障基金是人民群众的“看病钱”、“救命钱”，基本医疗保障制度建立以来，覆盖范围不断扩大、保障水平逐步提升，对维护人民健康权益、缓解因病致贫、推动医药卫生体制改革发挥了积极的作用。但是，受监管制度体系不健全、激励约束机制不完善等因素制约，医保基金使用效率不高，基金监管形势较为严峻。医保检查中，“挂床”、超范围经营、小病大治、过度检查用药、套高收费、分解收费、串换收费等欺诈骗保手段层出不穷。2018年国家医保局成立后，持续开展打击欺诈骗取医疗保障基金专项治理活动，对企图违法违规的现象起到了一定震慑作用。</p>
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