医保资金结余留用的法律问题与对策建议  

Legal Issues and Suggestions for the Retention of Medical Insurance Funds

作　　者：陈政[1] 朱玲[2] 陈隽[2] 李春厚[2] 王怡[2] 周炯[2] 向炎珍[2] Chen Zheng;Zhu Ling;Chen Jun;Li Chunhou;Wang Yi;Zhou Jiong;Xiang Yanzhen(Peking Union Medical College Hospital,Beijing,100730)

机构地区：[1]北京协和医院法务办,北京100730 [2]北京协和医院,北京100730

出　　处：《中国医疗保险》2022年第3期7-10,共4页China Health Insurance

基　　金：国家医疗保障局委托课题:“医保支付方式改革中有关法律问题研究。”。

摘　　要：我国在推行医保支付方式改革的过程中,为驱动医疗机构主动进行精细化管理,建立与医保的激励约束机制,相关部门纷纷出台结余资金由医疗机构留用的有关政策。本文通过系统梳理相关规定并结合对部分地区的调研,提出完善结余留用政策的若干建议,旨在推动结余资金管理的合法合规和科学高效。In the process of implementing the reform of medical insurance payment methods in China,in order to drive medical institutions to take the initiative to carry out refi ned management and establish a balance mechanism and incentive mechanism between hospitals and medical insurance,relevant policies have been introduced in various places to retain surplus funds by medical institutions.This article systematically sorts out the relevant laws and regulations on the retention of medical insurance funds,investigates the relevant regulations on the retention of surplus funds in some provinces and cities,and puts forward suggestions for improving and implementing the policies for the retention of surplus funds,so as to promote the legal,compliant,effi cient and standardized use and management of medical insurance funds.

关 键 词：医疗保险 结余留用 法律现状 对策建议 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]