摘要
我国社会保险经办机构与医保定点医疗机构签订的医疗服务协议在签订和实施过程中存在一些问题,笔者主要针对签订协议的双方地位、性质、纠纷解决的途径、社会保险经办机构对医疗机构的惩罚性及拒付医保费用等问题,进行了认真的研究分析和法律关系的梳理,并综合提出了通过立法明确社保经办机构的性质,建立医疗服务协议协商机制、医保纠纷诉讼和救济途径等方面的政策法律建议,以供相关行政部门决策参考。
There are some problems in awarding and implementing medical service contract between social medical insurance institutes and contracted medical institutes.The position between both sides,nature,the way on solving dispute and the right given social medical institutes to penalize contracted medical institutes and reflect to pay have been deeply analyzed.Suggestions that clear the nature of social medical institute by law,establish medical service contract negotiation mechanism,medical insurance dispute and help mechanism are presented to give reference on decision making.
出处
《中国医院》
2012年第1期13-17,共5页
Chinese Hospitals
关键词
医保协议
社保经办机构
协商机制
medical insurance contract
social medical insurance institute
negotiation mechanism
