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美国、德国医疗保险服务协议相关法律问题及对中国的启示
引用本文:陈定伟,曹艳林,Erin Hammers,刘方,袁江帆,吴迪,何欣薇.美国、德国医疗保险服务协议相关法律问题及对中国的启示[J].中国医院,2012,16(1):18-22.
作者姓名:陈定伟  曹艳林  Erin Hammers  刘方  袁江帆  吴迪  何欣薇
作者单位:1. 美国乔治城大学法学院,600 New Jersey Ave.NW,Washington,DC,20001,USA
2. 中国医学科学院卫生政策与管理研究中心,100020北京市
3. 北京市医疗纠纷人民调解委员会,100034北京市
4. 北京积水潭医院医患办,100035北京市
摘    要:重点对美国医疗保险经办机构和医疗机构的关系、医疗保险申请、医疗服务协议的协商谈判机制、工作程序、医疗保险的支付方式,经费报销结算计算及医保纠纷解决五步上诉机制等相关法律问题,以及德国的医疗保险模式和医疗服务协议相关情况进行了综述介绍,在此基础上论述了美、德医疗保险服务协议相关法律问题对我国的启示。

关 键 词:医疗保险  服务协议  美国  德国

Relative legal problems of medical insurance contract in United States and Germany and their revelation for China
CHEN Dingwei , CAO Yanlin , Erin Hammers , LIU Fang , YUAN Jiangfan , WU Di , HE Xinwei.Relative legal problems of medical insurance contract in United States and Germany and their revelation for China[J].Chinese Hospitals,2012,16(1):18-22.
Authors:CHEN Dingwei  CAO Yanlin  Erin Hammers  LIU Fang  YUAN Jiangfan  WU Di  HE Xinwei
Institution:CHEN Dingwei,CAO Yanlin,Erin Hammers,et al 600 New Jersey Ave.NW,Washington,DC,20001,USA
Abstract:Relative legal problems such as the relations between medical insurance agencies and medical institutes,medical insurance application,the negotiation mechanism,working process,payment methods,settling and 5 steps appeal mechanism in medical service contract in United States have been deeply analyzed.The medical insurance mode and its medical service contract in Germany also has been introduced.Furthermore,relative legal problems of medical insurance contract in United States and Germany and their revelation for China are discussed.
Keywords:medical insurance  service contract  United States  Germany
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