Medical Insurance Department: Complaints can be filed in case of forced discharge from hospital
“It has been 15 days since I was hospitalized, so let’s go for discharge, or the medical insurance will not reimburse me.” , Some citizens on the Internet reported that they encountered such a situation in hospital. Does the medical insurance department really have such regulations? In response, the Municipal Medical Insurance Bureau responded that the medical insurance department has no relevant regulations to force patients to be discharged from the hospital for 15 days. The number of days of hospitalization and the cost of treatment of the patient shall be subject to professional judgment by the medical institution based on the patient’s condition. If a patient is forced to be discharged from the hospital, he or she can file a complaint with the health insurance department.
For such internet rumors, what exactly is medical insurance? In this regard, this reporter interviewed the city’s medical insurance department. It is understood that there is no such provision in the medical insurance policy. This kind of behavior belongs to the decomposition of hospitalization. If verified, it should be dealt with seriously.
According to the relevant provisions of the “Regulations on the Supervision and Administration of the Use of Medical Insurance Funds”, designated medical institutions and their staff should implement the management regulations for real-name medical treatment and drug purchase, verify the medical insurance certificates of insured persons, and provide them in accordance with the diagnosis and treatment standards. Reasonable and necessary medical services, truthfully issue expense receipts and related materials to the insured, and shall not disaggregate hospitalization or hanging bed hospitalization… Article 38 stipulates that if designated medical institutions have disaggregated hospitalization or hanging bed hospitalization, the medical The administrative department of security shall order it to make corrections, and may interview the person in charge; if it causes losses to the medical security fund, it shall be ordered to return it, and a fine of not less than 1 time but not more than 2 times the amount of the loss caused shall be imposed; if it refuses to make corrections or causes serious consequences, it shall be ordered to designate a designated medical institution Suspend medical services involving the use of medical security funds by relevant responsible departments for more than 6 months and less than 1 year; those who violate other laws and administrative regulations shall be dealt with in accordance with the law by the relevant competent departments.
Decomposition of hospitalization refers to artificially dividing a continuous hospitalization process into two or even multiple hospitalizations without following the clinical discharge standards, or artificially dividing the insured personnel between hospitals and in-hospital departments. Frequent transfers between subjects. What should I do in a situation like being forced to leave the hospital? The medical insurance department said that if patients are forced to be discharged from the hospital, they can complain to the medical insurance department. Medical insurance service hotline 12393.