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<li id="c_h1">会泽?012年新型农村合作医疗实施方?/li>
<li id="c_h2"><span>来源：会泽县新型农村合作医疗管理委员会办公室 点击次数?script type="text/javascript" src="http://search.qjdwgk.gov.cn/click/default.ashx?id=12180"></script> 发布日期?012-09-25</span></li>
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<p class="msonormal" style="line-height: 29pt; text-indent: 64.95pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 2.94; mso-line-height-rule: exactly;"><strong style="mso-bidi-font-weight: normal;"><span style="font-family: 宋体; font-size: 22pt;">会泽?span lang="en-us">2012</span>年新型农村合作医?/span></strong></p>
<p class="msonormal" style="text-align: center; line-height: 29pt; margin: 0cm 0cm 0pt; mso-line-height-rule: exactly;" align="center"><strong style="mso-bidi-font-weight: normal;"><span style="font-family: 宋体; font-size: 22pt;">????/span></strong></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us"><span style="font-family: times new roman; font-size: x-large;"> </span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">为认真贯彻落实党中央、国务院和省委、省政府关于加快建设医疗保障体系的要求，根据《中共曲靖市?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us"> </span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">曲靖市人民政府关于进一步加强新型农村合作医疗管理的意见》，切实加强我县农村卫生工作，进一步巩固和完善新型农村合作医疗制度（以下简称新农合），结合我县实际，制定本实施方案?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">一、指导思想</span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm -16.3pt 0pt -16pt; mso-char-indent-count: 1.96; mso-para-margin-top: 0cm; mso-para-margin-right: -1.02gd; mso-para-margin-bottom: .0001pt; mso-para-margin-left: -1.0gd;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">以邓小平理论?ldquo;三个代表”重要思想为指导，深入学习实践科学发展观，认真贯彻《中共中央、国务院关于深化医药卫生体制改革的意见》，全面落实《医药卫生体制改革近期重点实施方案（</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2009-2011</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">年）》，逐步提高筹资标准，扩大受益面，提高保障水平；加强新农合制度建设强化基金统筹的监管力度，保证基金安全；巩固和发展新农合制度，实现无缝式覆盖；加快农村基本医疗保障体系建设，为实?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">“一卡?rdquo;工程奠定基础，实现人人享有基本医疗卫生服务的目标，进一步提高农民群众的健康水平?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">二、基本原?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（一）坚持政府组织引导，农民自愿参加的原?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">加强对广大农民进行宣传和引导，采取有效措施，把建立新农合制度的目的和意义、管理办法、参加人的权利和义务、减免补偿政策及方式等宣传到千家万户，不断树立农民群众的健康意识和互助意识，让广大农民自觉自愿参加新农合?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（二）参加人享受同等权利和义务的原则</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">凡全县辖区内的农村居民，履行缴费义务后，均享有参加新农合并得到医药费用减免和补偿的同等权利?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（三）加强基金管理，确保基金安全原则</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">经办机构负责审核支付费用，财政部门设立财政专户对基金进行管理，做到银行管钱不管帐，经办机构管账不管钱，基金收支分离、管用分开、封闭运行?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（四）坚持互助共济、大病统筹为主的原则</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">合理制定各级定点医疗机构的门诊、住院费用减免补偿比例，在新农合基金总额分配中，用于门诊费用的基金不超过</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">30</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％，用于大病统筹的基金不低于</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">70</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％。并逐步将卫生部、人力资源社会保障部、民政部、财政部、中国残联联发?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2010</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">80</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">号文件规定的</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">9</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">种残疾人康复训练纳入新型农村合作医疗报销?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（五）坚持县级统筹、属地管理的原则</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">新农合基金筹集、补偿和监督原则上以县为单位统筹管理。实行属地管理的原则，即参合人在户口所在地按规定缴纳参合费、享受医疗服务和合作医疗保障补偿等权利和承担相应的义务?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（六）坚持便民、利民的原则</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">新农合减免补偿程序应尽量精简，方便农民群众，提高新农合公信度。参合农民在县域内，可以自由选择定点医疗服务机构，并获得基本的医疗服务?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">三、目标任?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">加强制度建设，扩大新农合覆盖面，不断提高新农合的保障水平，巩固发展与农村经济社会发展水平和农村基本医疗需求相适应的、具有基本医疗保障性质的新农合制度，逐步缩小城乡居民之间的基本医疗保障差距。进一步调整、完善和执行统筹补偿方案，努力提高参合人住院费用实际补偿比例；新农合定点医疗机构药品实行跟标采购，采购的品种和数量均应占新农合用药的</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">80</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％以上，切实降低医药费用，让参合人得到更多的实惠，保持较高水平的参合率，促进新农合工作稳步健康向前发展?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">四、基金筹?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">（一）参合对象：我县辖区内的农村户籍人口，在户口所在地以户为单位参加新农合，新出生婴儿（属农业户籍）在出生?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">周内自愿缴费可以纳入当年参合对象?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';"><span style="font-family: times new roman;">（二?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">2012</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">年参合农民人均筹资标准为</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">290</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">元?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">其中：中央财政补?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">156</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，省级财政补助</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">84</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，农民以户为单位年人均缴纳新农合互助金</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">50</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">（三）农?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">独生子女的父母、年龄不?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">18</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">周岁的独生子女、只生育了两个女孩且采取了绝育措施的农村夫妻，由各乡（镇）计生办负责摸底调查，统计上报县计生局审核后，代缴个人缴纳部分?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">五保户、历史特困户、贫困残疾人等由各乡（镇）负责统计后，报县民政局等部门审核批准，代缴个人参合费用。除省、市安排的贫困人口医疗救助基金外，县财政据实安排贫困人口医疗救助基金纳入贫困医疗基金专户管理，用于补助特困人群中无力支付的医药费用自负部分?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">（四）为保证及时上报核拨中央和省级补助基金，参合农民必须?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">11</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">30</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">缴纳次年的新农合互助金，各乡（镇）的筹资情况?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">12</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">31</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">日前上报县合管办?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">五、补偿标?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（一）门诊补?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、设置门诊费补偿封顶线每人每?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">200</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，超过不再补偿。农民缴纳新农合参合费后，身体健康，未发生任何医疗费用者，不给任何补偿，所缴纳的参合费用于互助共济?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、到乡（镇）、村两级新农合定点医疗机构就诊的，门诊医药费?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">50%</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">直接减免?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、中药饮片门诊费用减免比例提?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">10%</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">4</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、设置乡、村门诊月平均处方值控制线，村?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">35</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，乡级</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">45</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">5</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、慢性病（原发性高血压、糖尿病），经会泽县人民医院鉴定，县合管办审批持证的，门诊减免在一个自然年度内，最高支付限额提高到每人</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">800</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（二）住院补?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、新农合定点医疗机构起付线及标准：乡（镇）级</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">100</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，县级</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">200</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，市级</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">400</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，省级</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">600</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元；</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2012</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">年内同级别定点医疗机构二次住院不设起付线。补偿比例：乡（镇）级定点医疗机?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">85</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％，曲靖市域内县级定点医疗机?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">75</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％，市内市级、市外县级或县级以上</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">50</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">％?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、残疾人、农业人口独生子女、只生育两个女孩且落实了绝育措施的家庭住院费用，补偿比例提高</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">10%</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">；肺癌、宫颈癌患者补偿比例提?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">10%</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">；纯中医、中药住院治疗补偿比例提?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">10%</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、住院补偿标准全年累计最高支付补偿限额为</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">60000</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，特殊疾病</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">70000</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元；超出部分不再补偿?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">特殊疾病：恶性肿瘤、肾功能衰竭、肝硬化、红斑狼疮、糖尿病、二级以上心功能不全、脑梗塞（脑出血）后的瘫痪、重性精神病?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: times new roman;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">4</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">农村孕产妇住院分娩，单胎顺产新农合基金乡级补?/span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">350</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">/</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">例，县级补助</span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">550</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">/</span><span style="font-family: times new roman;"><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">例；</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">阴道手术助产</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">乡级补助</span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">550</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">/</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">例，县级补助</span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">800</span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="layout-grid-mode: line; font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-font-kerning: 0pt;" lang="en-us">/</span><span style="font-family: times new roman;"><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">例；</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-bidi-font-weight: bold; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;">剖宫产乡级补?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-bidi-font-weight: bold; mso-bidi-font-family: 宋体;" lang="en-us">1600</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-bidi-font-weight: bold; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;"><span style="font-family: times new roman;">元，县级补助</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简? mso-bidi-font-weight: bold; mso-bidi-font-family: 宋体;" lang="en-us">2100</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-bidi-font-weight: bold; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;">元；?/span><span style="layout-grid-mode: line; font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-font-kerning: 0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">外住院分娩的按照住院补偿标准执行?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">5</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、属于民政代缴合作医疗互助金的农村五保户、历史特困户、贫困残疾人等，因患白内障进行白内障手术治疗的，给予每例一次性定额补?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1000</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，不按比例补偿。农村截肢残疾人，由残联组织安装假肢的，实行农村合作医疗足额补助，大腿每例补?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2350</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元，小腿每例补助</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">950</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元。本人凭发票和有关证件到各乡（镇）合管办报销?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">6</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、《云南省卫生厅关于印发新型农村合作医疗基本诊疗项目（试行）的通知》（云卫?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2008</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1159</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">号）中，所有带“?rdquo;号的诊疗项目全部纳入报销范围，包括诊疗项目中使用的耗材和药品；国家基本用药目录和云南省补充目录纳入新农合报销范围；远程医疗会诊费用纳入新农合补偿范围?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: times new roman;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">7</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、到市级以上定点医疗机构就诊?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">200</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元以下的医用耗材国产和进口的都可以报销?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">200</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">元以上的医用耗材国产的可以报销?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">床位费每人每日最高不得超?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">40</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">,</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">据实按规定比例补偿?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">8</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、精神病人在市级定点医院住院治疗的，按县级住院补偿标准执行，在省级定点医疗机构住院的，按市级住院补偿标准执行?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: times new roman;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">9</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">0</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">——</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">14</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">周岁（含</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">14</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">周岁）参合儿童，凡患有急性淋巴细胞白血病、急性早幼粒细胞白血病、先天性房间隔缺损、先天性室间隔缺损、先天性动脉导管未闭、先天性肺动脉瓣狭窄等</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">6</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">种疾病。凡属单病种的，携带合作医疗本、户口薄等相关资料到县合管办申请办理转诊治疗审批手续，就医补偿程序按《云南省卫生?/span></span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">云南省民政厅关于扩大云南省提高农村儿童重大疾病医疗保障水平试点工作范围的通知》（云卫?/span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;">?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">2011</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;"><span style="font-family: times new roman;">?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">639</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">号）精神办理?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（三）限价收费标?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">农村孕产妇在县级医疗保健机构和乡镇卫生院住院分娩实行限价政策，限价标准如下：正常产（含会阴切开与缝合术），乡镇卫生院每例限?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">750</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">元以内，县级医疗保健机构每例限价</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">950</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">元以内；阴道手术助产（胎头吸引、产钳、臀位助产、臀位牵引术），乡镇卫生院每例限?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">950</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">元以内，县级医疗保健机构每例限价</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">1200</span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">元以内；</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-bidi-font-weight: bold; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体; mso-bidi-font-family: 宋体;">剖宫产，</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">乡镇卫生院每例限?/span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us">2000</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;"><span style="font-family: times new roman;">元以内，县级医疗保健机构每例限价</span></span><span style="font-family: 宋体; mso-bidi-font-size: 16.0pt; mso-fareast-font-family: 方正仿宋简?" lang="en-us"> 2500 </span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 宋体; mso-hansi-font-family: 宋体;">元以内?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（四）补偿程?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、在县内各级新农合定点医疗机构就诊的参合人员，应提供《新型农村合作医疗证》、身份证或户口薄，由医务人员核实其参合身份；出院时，凭住院发票、费用清单、病情诊断证明书、出院小结或出院记录、出院证原件和身份证（户口薄）、新型农村合作医疗证，由各定点医疗机构现场办理补偿?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、参合人员因病到县内各定点医疗机构住院的，不需办理转诊转院手续。凡需转诊到县外县级以上定点医疗机构治疗的，必须经过县级医疗机构填具《云南省新型农村合作医疗转诊治疗审批表》，报送县合管办审批。外出务工人员在务工地的县级以上政府举办的公立医疗机构住院的，可凭外出务工证明，到户口所在地的乡（镇）合管办办理补偿?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、参加商业保险的参合人员补偿医疗费用时，必须先持相关资料到相应的定点医疗机构或合管办办理补偿手续，再到保险机构办理理赔给付?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（五）下列情形，新农合不予补?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、各种美容、整形、健美手术及使用整形、健美器具等一切费用?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、酗酒闹事、打架斗殴、交通事故、吸毒、自杀等及其它因犯罪或违反《治安管理处罚法》所致伤病的?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、有第三者或其他赔付责任的医疗费?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">,</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">因医疗事故或纠纷应由医方承担的费用?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">4</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、就诊车旅费、急救车费、会诊费（远程医疗会诊除外）、体检费?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">5</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、住院期间的陪床费、本人要求享受的特殊病房及手术病人安全保险费?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">6</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、属政府公共卫生服务已确定支付范围的费用?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">7</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、实施计划生育手术和违反计划生育政策怀孕产生的费用?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">六、保障措?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（一）加强领导，精心组织</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">县新农合管理机构要根据国家、省、市、县相关文件精神和实施情况，制定全县年度新农合实施方案等相关配套政策。在全县医疗机构中择优选择新农合定点服务机构，并加强对定点机构的监管力度，实行动态管理，落实各种诊疗规范和管理制度，控制医疗费用。同时，加强基金的监督管理，确保参合农民受益?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">各乡（镇）加强辖区内新农合实施工作的组织领导，加强村卫生所建设，巩固集体办医，认真贯彻执行卫生法律、法规，在委托授权范围内开展辖区内医疗机构和药品市场的清理整顿。下达村卫生所的初保、预防、保健、医疗业务工作指标，定期检查、指导、考核，兑现奖惩；编制或执行各类业务月、季、年报表，全面实施乡（镇）村卫生服务一体化管理制度，保证各项任务的完成。村级新农合管理机构要认真组织协调完成上级下达的初保、医疗、预防、保健、健康教育、参合人员互助金的收缴等各项指标；监督村卫生所每月向乡（镇）合管办报一次财务报表，交一次现金，上一次台帐，报一次医疗、预防、保健等业务资料；对就诊、购药者全部实行处方开单、门诊登记及传染病报告等制度。在每年度换发新农合证件时，乡（镇）合管办应组织抽调人员及时、准确地将换填好的《新型农村合作医疗证》送到参合农民手中。新农合相关的表、卡、证由县合管办统一印制下发，不对参合人员收取任何费用?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（二）明确职责，密切配合</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">新农合制度是由政府组织、引导、支持，农民自愿参加，个人、集体、政府多方筹资，以大病统筹为主的农民医疗互助制度。各级各相关部门要进一步统一思想，提高认识，认真履行职责，加强协调配合，共同推进新农合工作。卫生部门作为新农合工作的牵头单位，要切实加强对此项工作的具体指导和组织实施，加强调查研究，当好政府参谋；财政部门要积极做好基金的使用、管理和监督工作，及时落实配套基金，保证此项工作的顺利实施；农业部门要做好政策的宣传和解释工作；人事部门要会同卫生部门做好合管办人员的调配工作；公安部门要协助做好参合人员的户口界定工作；广电部门要积极做好农村合作医疗的宣传工作；发展和改革部门要对定点医疗机构的收费标准进行监督检查，及时查处纠正超标准的医疗收费行为；审计部门要及时对合作医疗基金的收支、运行、补偿情况进行审计?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">启动贫困医疗救助基金，实施贫困医疗救助。具体救助办法由民政部门制定?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 方正楷体简? mso-bidi-font-size: 16.0pt;"><span style="font-family: times new roman;"><span style="font-size: x-large;">（三）严明纪律，加强监管</span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、加强基金的监督与管理。建立健全新农合的监督检查制度和投诉处理制度，定期对县、乡（镇）、村三级医疗机构进行监督、指导、检查，对新农合工作的投诉应及时进行查处。审计部门应定期对新农合基金管理、划拨、使用进行审计。县、乡（镇）和村级定点医疗机构应建立和完善门诊减免登记制度、规范服务和合理用药制度、信息公开制度，自觉接受群众和社会的监督?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、对违反下列行为，情节较轻的，限期改正；情节较重的，按有关规定对主管人员和直接责任人给予处罚，触犯刑律的依法追究刑事责任。（</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">）截留、挤占、挪用、贪污基金；?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">）违背新农合章程、办法和制度，擅自改变补偿项目或补偿比例；（</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">）未将基金及利息等收入存入新农合专户；（</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">4</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">）弄虚作?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">,</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">将合作医疗证转借他?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">;</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">5</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">）其它违反国家法律、法规规定的行为?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">3</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、乡村医生违反执业规则的行为，按《乡村医生从业管理条例》有关规定处理?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;"><span style="font-size: x-large;">七、附?/span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">（一）本实施方案中所指的定点医疗机构包括?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、省、市定点医疗机构，县外县级及以上政府举办的公立医疗机构?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">、会泽县县、乡、村定点医疗机构。县内县级定点医疗机构：会泽县人民医院、会泽县人民医院分院、会泽县中医院、会泽县妇幼保健院、以礼河电厂职工医院、会泽县计划生育技术服务站；县内乡级定点医疗机构：者海中心卫生院等</span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">21</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">家乡（镇）卫生院；县内村级定点医疗机构：金钟镇龙潭社区卫生服务站?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">19</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">个社区卫生服务站和金钟镇赵家村卫生所?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">357</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">个村卫生所?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-family: times new roman;"><span style="font-size: x-large;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">（二）本实施方案?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2012</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">1</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">日开始施行，?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">2012</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">12</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">?/span><span style="mso-bidi-font-size: 16.0pt;" lang="en-us">31</span><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">日终止?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="font-size: x-large;"><span style="font-family: 黑体; mso-bidi-font-size: 16.0pt;">八?/span><span style="font-family: times new roman;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';">本实施方案由会泽县合管办负责解释?/span></span></span></p>
<p class="msonormal" style="text-indent: 31.35pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 1.96;"><span style="mso-bidi-font-size: 16.0pt;" lang="en-us"><span style="font-family: times new roman; font-size: x-large;"> </span></span></p>
<p class="msonormal" style="text-indent: 258.7pt; margin: 0cm 0cm 0pt; mso-char-indent-count: 16.17;"><span style="font-family: 方正仿宋简? mso-bidi-font-size: 16.0pt; mso-ascii-font-family: 'times new roman';"><span style="font-family: times new roman; font-size: x-large;">二〇一二年一月十六日</span></span></p>
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