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| 基本医疗保险服务协议存在的问题及政策建议 | |
| 引用本文： | 王霞,郑雪倩,高树宽,睢素利,李敬伟,刘方,田献氢,陈定伟.基本医疗保险服务协议存在的问题及政策建议[J].中国医院,2012,16(1):13-17. |
| 作者姓名： | 王霞 郑雪倩 高树宽 睢素利 李敬伟 刘方 田献氢 陈定伟 |
| 作者单位： | 1. 北京交通大学人文学院,100044北京市 2. 中国医院协会医疗法制专业委员会,100081北京市 3. 北京协和医学院,100730北京市 4. 北京大学第一医院,1 00034北京市 5. 北京市医疗纠纷人民调解委员会,100034北京市 6. 卫生部中日友好医院医保办,100029北京市 7. 美国乔治城大学法学院,600 New Jersey Ave.NW, Washington,DC,20001,USA |
| 摘 要： | 我国社会保险经办机构与医保定点医疗机构签订的医疗服务协议在签订和实施过程中存在一些问题,笔者主要针对签订协议的双方地位、性质、纠纷解决的途径、社会保险经办机构对医疗机构的惩罚性及拒付医保费用等问题,进行了认真的研究分析和法律关系的梳理,并综合提出了通过立法明确社保经办机构的性质,建立医疗服务协议协商机制、医保纠纷诉讼和救济途径等方面的政策法律建议,以供相关行政部门决策参考。 |
| 关 键 词： | 医保协议 社保经办机构 协商机制 |
Problems and suggestions on basic medical insurance contract |
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| WANG Xia , ZHENG Xueqian , GAO Shukuan , SUI Suli , LI Jingwei , LIU Fang , TIAN Xianqing , CHEN Dingwei.Problems and suggestions on basic medical insurance contract[J].Chinese Hospitals,2012,16(1):13-17. | |
| Authors: | WANG Xia ZHENG Xueqian GAO Shukuan SUI Suli LI Jingwei LIU Fang TIAN Xianqing CHEN Dingwei |
| Institution: | WANG Xia,ZHENG Xueqian,GAO Shukuan,et al School of Humanity and Social Science,Beijing Tiaotong University,No.3,Shangyuan Cun,Haidian District,Beijing,100044,PRC |
| Abstract: | There are some problems in awarding and implementing medical service contract between social medical insurance institutes and contracted medical institutes.The position between both sides,nature,the way on solving dispute and the right given social medical institutes to penalize contracted medical institutes and reflect to pay have been deeply analyzed.Suggestions that clear the nature of social medical institute by law,establish medical service contract negotiation mechanism,medical insurance dispute and help mechanism are presented to give reference on decision making. |
| Keywords: | medical insurance contract social medical insurance institute negotiation mechanism |
| 本文献已被 CNKI 维普 万方数据 等数据库收录！ | |