在实现全民医保的背景下,就医人次、频次呈增加态势,随之而来的医保基金监管方面的问题也凸显出来,特别是安徽太和医疗机构欺诈骗保事件曝光后,引起社会各界对医保基金监管的关注。本文就如何破解基层医疗机构医保基金监管难题,从建立医保管理制度、健全医保基金监管体制、完善基金监管机制等方面介绍枞阳县在强化医保基金监管工作中的经验做法,并对工作中存在的问题提出对策和建议。

China has put in place the basic medical insurance network covering the entire population, the number and frequency of people who seek medical service increases. However, the problems in the supervision of medical insurance funds are also obvious, especially after the fraud incidents of medical institutions in Taihe County, Anhui Province, which caused much concern on the supervision of medical insurance funds. This paper mainly discusses how to solve the problem of medical insurance fund supervision in primary medical institutions, and introduces the experience of Zongyang County in strengthening the supervision of medical insurance funds from the aspects of establishing a medical insurance management system, and improving the medical insurance fund supervision system as well as the fund supervision and restraint mechanism.