摘要
国务院日前发布的《医疗保障基金使用监督管理条例》(以下简称《条例》)为医疗保障基金监管执法提供了法律依据、细化了法律责任、加大了惩戒力度。尽管《条例》在很大程度上解决了执法依据不足问题,但现阶段医保基金监管仍然存在执法资源有限和处罚效果具有外部性等问题。本文拟在深入分析现阶段执法存在问题的基础上,提出解决问题的建议,即从现行的最严执法理念转为最优执法理念,并根据最优执法理念给出了医保监管共治的实现路径和具体建议。
The Regulations on the Supervision and Administration of the Use of Healthcare Security Fund recently issued by the State Council provides a legal basis for the supervision and law enforcement of healthcare security fund,which not only refines the legal responsibility,but also increases the punishment.Although the regulations to a large extent solves the problem of insuffi cient basis for supervision and law enforcement,there are still some problems in the supervision of healthcare security fund,such as limited law enforcement resources and externality of punishment eff ect.Based on the in-depth analysis of the main problems in law enforcement at this stage,this paper proposes that the law enforcement concept should be changed from the current most stringent law enforcement to the optimal law enforcement,and according to the optimal law enforcement concept,gives the realization path and specifi c suggestions of the co-governance of healthcare security supervision.
作者
张卿
Zhang Qing(Institute of Law and Economics,China University of Political Science and Law,Beijing,100088)
出处
《中国医疗保险》
2021年第5期35-39,共5页
China Health Insurance
基金
国家医疗保障局委托课题《医疗保障监管方式和程序法律机制研究》的阶段性成果。
关键词
医疗保障基金
监管
最优执法目标
共治路径
healthcare security fund
supervision
optimal law enforcement target
co-governance path
