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on september 27, the national medical insurance administration held a press conference to introduce the relevant situation of "establishing a medical insurance payment qualification management system for relevant personnel of designated medical institutions."

yan qinghui, deputy director of the national medical insurance administration, said that the national medical insurance administration has fully learned from and absorbed the experience of establishing and improving medical insurance payment qualification management in various places in the past 20 years, and carries out score management for relevant responsible persons of designated medical institutions. medical personnel must abide by diagnosis and treatment standards. in order to further promote the implementation of management measures, the national medical insurance administration, the national health commission, and the state food and drug administration jointly issued guidance, clarifying key contents such as management objectives, basic principles, scoring standards, and supervision and management. this is the chief supervisor of the medical insurance fund. a landmark achievement in the construction of effective mechanism.

yan qinghui introduced that a series of laws, regulations and policies such as the "guiding opinions on promoting the reform of the medical security fund supervision system" and the "regulations on the supervision and management of the use of medical security funds" have clearly stated that the focus of supervision will shift from medical expense control to medical expenses and medical services. performance control, and gives the medical insurance department the authority to take measures to suspend medical insurance payment qualifications for violators.

the national medical insurance administration resolutely implements the decisions and arrangements of the party central committee and actively strengthens collaboration with the national health commission, the state food and drug administration and other departments. with the support of various departments, the establishment of a medical insurance payment qualification management system is regarded as an important plan for improving the medical insurance fund supervision system and the implementation is fully promoted.

yan qinghui said that establishing a medical insurance payment qualification management system for relevant personnel of designated medical institutions is an urgent need to solve the practical problems of medical insurance fund supervision. in recent years, the supervision of medical insurance funds has been continuously strengthened, but the illegal use of medical insurance funds by designated medical institutions is still repeatedly investigated and banned. the traditional supervision model can only punish pharmaceutical institutions and cannot "supervise and punish people". this is an important reason. this traditional supervision model not only emboldens a small number of people who violate laws and regulations, but is also unfair to those who comply with laws and regulations. by establishing a medical insurance payment qualification management system, the regulatory reach is extended to specific responsible persons, and those responsible for violations are scored and managed, which highlights the accuracy of supervision and allows violators to pay their due price, which can effectively curb the abuse of medical insurance funds. at the same time, this is also the protection of pharmaceutical-related personnel who comply with laws and regulations.