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    年底前生育保險與醫療保險合并 確保職工生育期間生育保險待遇不變

    作者:佚名   來源:新華社   日期:2019-03-26 07:42:38
    導讀:近日,國務院辦公廳印發《關于全面推進生育保險和職工基本醫療保險合并實施的意見》(以下簡稱《意見》)。
      近日,國務院辦公廳印發《關于全面推進生育保險和職工基本醫療保險合并實施的意見》(以下簡稱《意見》)。

     

      確保職工生育期間生育保險待遇不變
     

      《意見》指出,要以習近平新時代中國特色社會主義思想為指導,認真落實黨中央、國務院決策部署,堅持以人民為中心,牢固樹立新發展理念,遵循保留險種、保障待遇、統一管理、降低成本的總體思路,推進生育保險和職工基本醫療保險合并實施,實現參保同步登記、基金合并運行、征繳管理一致、監督管理統一、經辦服務一體化。通過整合兩項保險基金及管理資源,強化基金共濟能力,提升管理綜合效能,降低管理運行成本,建立適應我國經濟發展水平、優化保險管理資源、實現兩項保險長期穩定可持續發展的制度體系和運行機制。
     

      《意見》提出了推進生育保險和職工基本醫療保險合并實施的主要政策。一是統一參保登記。參加職工基本醫療保險的在職職工同步參加生育保險。完善參保范圍,促進實現應保盡保。二是統一基金征繳和管理。生育保險基金并入職工基本醫療保險基金,統一征繳,統籌層次一致。按照用人單位參加生育保險和職工基本醫療保險的繳費比例之和確定新的單位費率。三是統一醫療服務管理。兩項保險合并實施后實行統一定點醫療服務管理,執行基本醫療保險、工傷保險、生育保險藥品目錄以及基本醫療保險診療項目和醫療服務設施范圍。生育醫療費用原則上實行醫療保險經辦機構與定點醫療機構直接結算。促進生育醫療服務行為規范,強化監控和審核。四是統一經辦和信息服務。經辦管理統一由基本醫療保險經辦機構負責,實行信息系統一體化運行。五是確保職工生育期間生育保險待遇不變。參保人員生育醫療費用、生育津貼等各項生育保險待遇按現行法律法規執行,所需資金從職工基本醫療保險基金中支付。六是確保制度可持續。各地要增強基金統籌共濟能力,增強風險防范意識和制度保障能力,合理引導預期,完善生育保險監測指標,根據生育保險支出需求建立費率動態調整機制。
     

      兩項保險合并實施并非取消生育保險
     

      《意見》要求,各地要高度重視生育保險和職工基本醫療保險合并實施工作,根據當地生育保險和職工基本醫療保險參保人群差異、基金支付能力、待遇保障水平等因素進行綜合分析和研究,周密組織實施,確保參保人員相關待遇不降低、基金收支平衡,保證平穩過渡。各省(自治區、直轄市)要加強工作部署,督促指導各統籌地區加快落實,2019年底前實現兩項保險合并實施。
     

      國家醫保局副局長陳金甫25日在國務院政策例行吹風會上表示,全面推進生育保險和職工基本醫療保險合并實施將確保職工生育期間生育保險待遇不變,確保制度可持續。
     

      生育保險對維護職工生育保障權益、促進婦女公平就業、均衡用人單位負擔、保障職業婦女生育期間基本生活和身體健康發揮了重要作用。陳金甫表示,兩項保險合并實施并非取消生育保險,而是從提升公共治理效能、減輕單位和參保人員負擔、提升基金共濟能力、規范運行的角度,進行管理層面上的合并實施。

     

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