Quota management of pneumoconiosis hospitalization expenses of industrial workers in Chongqing

1n order to effectively protect the medical needs of the workers suffering from pneumoconiosis and make rational and effective use of the work-related injury insurance fund, the Municipal Bureau of human resources and social security and the Municipal Bureau of Finance jointly issued a document. From November 1, 2013, the settlement method of medical expenses for pneumoconiosis inpatients under the overall management of work-related injury insurance was adjusted and the fixed settlement management was implemented

first, the limit management of pneumoconiosis inpatient medical expenses of industrial injury personnel was adjusted to the quota management according to disease type. 1f it is necessary to use the work-related injury insurance fund due to the patient’s condition, the expenses of drugs and medical services beyond the scope of payment shall be included in the scope of fixed settlement, and medical institutions shall not charge additional fees from employers or work-related injury personnel

Second, in special cases such as lung lavage or rescue, the medical institution shall report to the work-related injury insurance agency with which the service agreement is signed. After approval, the relevant medical expenses shall be paid by the work-related injury insurance fund

thirdly, medical institutions are not allowed to limit the hospitalization expenses of workers with occupational pneumoconiosis according to the settlement standards, to shorten or extend the hospitalization time at will to maximize the settlement benefits, to reduce the medical quality, and to shirk responsibility and refuse serious patients

China labor insurance net

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