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央视暗访北京三甲医院:号贩子没走 票贩子来了

2016-12-04 17:53:48   央视

同时,由于目前我国尚未建立全国省(区)、市、县共享的医疗信息平台,审核过程中,如果对报账人提供的材料有疑问,只能亲自到医院核实。以安岳县为例,全县总人口数163万,是四川人口第一大县。同时也是劳动人口输出大县,全县每年外出务工人员60多万,异地住院就医近3万人次左右,就诊的医疗机构更是遍及全国各地,一一核实这些材料,难度可想而知。

全国医保信息系统亟待建立异地就医结报正加紧推进

可以看到,犯罪分子正是钻了全国医保系统尚未联网,异地审核难度大的空子,那么,骗取“新农合”基金的问题到底该如何解决?

据国家卫生计生委基层卫生司监察专员聂春雷介绍,2004到2005年时当时的卫生部就对新农合信息制度化建设提出过指导意见,2011年国家级新农合信息系统建成,并逐步把国家信息系统和各省信息系统进行互联。

 

现在困难在什么地方?聂春雷解释,我们国家医疗机构太多,而且过去信息化建设滞后,一个医院一个信息系统,一个医院一个孤岛,信息都不互联互通,缺乏统一的顶层设计。现在要加强医疗机构互联互通,工作量很大,正在逐步推进。

今年4月6日,国务院召开常务会议,确定2016年深化医药卫生体制改革重点,其中就包括推进基本医保全国联网和异地就医结算。11月18日,辽宁、吉林、黑龙江、海南、四川、贵州、陕西、甘肃8省签署了新农合跨省就医联网结报服务协议,明确协议省份内参合患者经转诊至协议省份的定点联网机构就医,便可享受出院窗口直接结算报销服务,这也标志着新农合跨省就医联网结报工作试点正式启动。聂春雷说,如果2017年底,能解决异地就医结报问题,就基本上可根除骗保难题。

责任编辑:马少騄 CN061
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