我国已针对涉第三人情形下医保基金的先行支付制度构建起相应的法律体系,初步形成了较为完善的法律规制框架,为医保基金的先行支付及后续追偿提供了基础性法律保障。然而,现行法律规制仍存在法律规定内容缺漏、相关法律法规落实不到位、制度宣传不足等问题,导致在实践中,涉第三人医保基金的先行支付面临线索发现困难、追偿效率偏低等现实困境。为有效应对上述问题,有必要进一步完善医保基金先行支付相关法律规范的具体内容,强化法律法规的执行与落实效果,并加强制度宣传以提高社会公众的认知水平,从而系统性地健全我国涉第三人情形下医保基金先行支付的法律规制体系。
Abstract
China has introduced corresponding laws and regulations regarding the advance payment system of medical insurance funds in cases involving third parties, and has initially established a relatively complete legal regulatory framework, providing a basic legal guarantee for the advance payment and subsequent recovery of medical insurance funds. However, existing legal regulations still have issues such as gaps in legal provisions, inadequate implementation of laws and regulations, and insufficient promotion of system, which in turn leads to difficulties in discovering clues for advance payment by medical insurance funds in third-party cases and low efficiency in recovery in current practice. To address these challenges, the content of relevant legal laws and regulations for advance payment of medical insurance funds should be improved, their enforcement strengthened, and legal publicity enhanced to raise public awareness, further improving the legal regulatory system for advance payment of medical insurance funds in cases involving third parties in China.
关键词
医保基金 /
先行支付 /
第三人 /
法律规制
Key words
medical insurance fund /
advance payment /
third party /
legal regulation
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